Provider Demographics
NPI:1730433236
Name:WALKERLAY HOME HEALTHCARE
Entity type:Organization
Organization Name:WALKERLAY HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-709-4300
Mailing Address - Street 1:430 DOT DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-2704
Mailing Address - Country:US
Mailing Address - Phone:404-919-6675
Mailing Address - Fax:
Practice Address - Street 1:430 DOT DR
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-2704
Practice Address - Country:US
Practice Address - Phone:404-919-6675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251B00000X, 253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care