Provider Demographics
| NPI: | 1881989499 |
|---|---|
| Name: | HARPER'S ADULT DAY CARE, LLC |
| Entity type: | Organization |
| Organization Name: | HARPER'S ADULT DAY CARE, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CAROLYN |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | HARPER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 706-678-6072 |
| Mailing Address - Street 1: | 186 BOOTLEGGER LN E |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WASHINGTON |
| Mailing Address - State: | GA |
| Mailing Address - Zip Code: | 30673-5364 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 706-678-6072 |
| Mailing Address - Fax: | 706-678-6071 |
| Practice Address - Street 1: | 186 BOOTLEGGER LN E |
| Practice Address - Street 2: | |
| Practice Address - City: | WASHINGTON |
| Practice Address - State: | GA |
| Practice Address - Zip Code: | 30673-5364 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 706-678-6072 |
| Practice Address - Fax: | 706-678-6071 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2011-06-10 |
| Last Update Date: | 2011-06-10 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| GA | 2011 000616 | 261QA0600X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |