Provider Demographics
NPI:1538412184
Name:HEALING HANDS HOME HEALTH AGENCY,LLC
Entity type:Organization
Organization Name:HEALING HANDS HOME HEALTH AGENCY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-246-5865
Mailing Address - Street 1:PO BOX 1826
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-1028
Mailing Address - Country:US
Mailing Address - Phone:470-246-5865
Mailing Address - Fax:
Practice Address - Street 1:4440 IDLEWOOD PARK
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6247
Practice Address - Country:US
Practice Address - Phone:470-246-5865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health