Provider Demographics
NPI:1942199054
Name:EBENEZER PRIVATE HOMECARE INC
Entity type:Organization
Organization Name:EBENEZER PRIVATE HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:THOMPSON-PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-542-8702
Mailing Address - Street 1:5260 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-3122
Mailing Address - Country:US
Mailing Address - Phone:678-542-8702
Mailing Address - Fax:770-404-7333
Practice Address - Street 1:5260 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-3122
Practice Address - Country:US
Practice Address - Phone:678-542-8702
Practice Address - Fax:770-404-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health