MEDICARE: HCF PREVENTATIVE SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	251V00000X	Voluntary or Charitable Agency
3	347C00000X	Private Vehicle
4	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1043010424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HCF PREVENTATIVE SERVICES, INC.

Provider Business Mailing Address
First Line	:	957 MAIN ST STE A-108
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3060
Country	:	US
Telephone Number	:	470-336-2149
Fax Number	:

Provider Business Practice Location Address
First Line	:	957 MAIN ST
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3060
Country	:	US
Telephone Number	:	470-336-2149
Fax Number	:

Authorized Official
Title or Position	:	COGNITIVE BEHAVIORAL COACH
Name	:	HONIDU MARICO
Credential	:	CHW
Telephone Number	:	470-336-2149

Provider Enumeration Date	:	03/15/2025
Last Update Date	:	03/30/2026

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