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General NPI Number Information
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NPI Number | 1972388718
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Entity Type | Organization
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Legal Business Name | IMPLIED HUMAN DYNAMICS PERSONAL CARE HOME
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 3296 HIGHPOINT CT
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City | SNELLVILLE
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State | GA
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Zip | 30078-7401
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Country | US
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Telephone | 719-517-6905
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Fax |
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Provider Business Mailing Address
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Address Line | 3296 HIGHPOINT CT
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City | SNELLVILLE
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State | GA
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Zip | 30078-7401
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Country | US
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Telephone | 470-945-2646
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Fax | 470-945-2677
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Authorized Official
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Title or Position | CEO
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Name | SHARON PEART
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Credential | PAS
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Telephone | 470-945-2646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2278H0200X
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Taxonomy Name | Home Health Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2279H0200X
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Taxonomy Name | Home Health Registered Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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