Provider Demographics
NPI:1861556854
Name:RHEMA HOUSING INC.
Entity type:Organization
Organization Name:RHEMA HOUSING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-949-0108
Mailing Address - Street 1:6554 SPRING ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-1897
Mailing Address - Country:US
Mailing Address - Phone:770-949-6510
Mailing Address - Fax:770-949-2037
Practice Address - Street 1:6554 SPRING ST
Practice Address - Street 2:SUITE C
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-1897
Practice Address - Country:US
Practice Address - Phone:770-949-6510
Practice Address - Fax:770-949-2037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00972892AMedicaid