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General NPI Number Information
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NPI Number | 1801267943
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Entity Type | Individual
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Provider Name | NAOMI HARRIS
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Gender | Female
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 836 FAYETTEVILLE RD SE
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City | ATLANTA
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State | GA
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Zip | 30316-2913
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Country | US
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Telephone | 404-924-9534
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Fax |
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Provider Business Mailing Address
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Address Line | 2112 BRANNEN RD SE
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City | ATLANTA
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State | GA
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Zip | 30316-4118
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Country | US
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Telephone | 404-924-9534
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 20235650129
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License Number State | GA
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