MEDICARE: HATHROCK HEALTHCARE NETWORK, LLC/

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	372500000X	Chore Provider
3	372600000X	Adult Companion
4	373H00000X	Day Training/Habilitation Specialist
5	101Y00000X	Counselor

General Provider Information

NPI Number	:	1497690051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HATHROCK HEALTHCARE NETWORK, LLC/

Provider Business Mailing Address
First Line	:	817 PAVILION CT
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-6666
Country	:	US
Telephone Number	:	470-357-2974
Fax Number	:	404-923-9933

Provider Business Practice Location Address
First Line	:	817 PAVILION CT
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-6666
Country	:	US
Telephone Number	:	470-357-2974
Fax Number	:	404-923-9933

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. MICHAEL E. CANTY SR.
Credential	:
Telephone Number	:	470-357-2974

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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