EBENEZER HEALTHCARE SERVICES (NPI# 1285005645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285005645 |
| Entity Type | Organization |
| Organization Name | EBENEZER HEALTHCARE SERVICES |
| Practice Address |
5380 Peachtree Industrial Blvd Suite 247 Ab Norcross GA 30071-4713 |
| Mailing Address |
5380 Peachtree Industrial Blvd Ste 247 Norcross GA 30071-1592 |
| Practice Telephone | 4702994564 |
| Mailing Telephone | 4702994564 |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2015-10-12 |
| Authorized Official Name | MYUNG S SONG (OWNER) |
| Authorized Official Telephone | 47029945464 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253Z00000X | In Home Supportive Care | 067-R-1183 | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003160947A | 05 |
| Street Address |
5380 PEACHTREE INDUSTRIAL BLVD SUITE 247 AB |
| City | NORCROSS |
| State | GA |
| Zip Code | 30071-4713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821323072 | Macky Enterprises PC | Pediatrics | 5380 Peachtree Industrial Blvd, 140, Norcross, GA 30071-4713 | 2009-10-06 |
| 1134487010 | Medical Exams Direct | Home Infusion | 5380 Peachtree Industrial Blvd, Suite 247 A/b, Norcross, GA 30071-4713 | 2012-04-27 |
| 1396013322 | Macky Enterprises P.C. | Clinic/Center | 5380 Peachtree Industrial Blvd, Ste 140, Norcross, GA 30071-4713 | 2011-12-05 |
| 1386940419 | Macky Enterprises P.C. | Pain Medicine | 5380 Peachtree Industrial Blvd, Ste 150, Norcross, GA 30071-4713 | 2011-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477199867 | 1st Senior Cares, LLC | Home Health | 7116 Peachtree Industrial Blvd. Bldg. 4, Ste. B, Peachtree Corners, GA 30071 | 2019-11-21 |
| 1124660048 | Phil Scafidi | Massage Therapist | 50 Skin Alley, Norcross, GA 30071 | 2019-10-11 |
| 1063071454 | Kenanesha Owens | Counselor | 3040 Holcolmb Bridge Rd Suite J2, Norcross, GA 30071 | 2019-06-10 |
| 1407318389 | 1st Senior Homecare, LLC | Home Health | 7116 Peachtree Industrial Blvd., Bldg 4 Suite A, Peachtree Corners, GA 30071 | 2019-04-01 |
| 1982163689 | Jk Acupuncture LLC | Acupuncturist | 5390 Peachtree Industrial Bl #101, Norcross, GA 30071 | 2019-03-13 |
| 1063990778 | First Senior Center | Clinic/Center | 7116 Peachtree Industrial Blvd, Bldg 4, Peachtree Corners, GA 30071 | 2018-08-03 |
| 1952896904 | Sonal P Patel | Physical Therapy Assistant | 4709 Peachtree Ind Blvd, Suite 106, Norcross, GA 30071 | 2018-06-22 |
| 1700392354 | Medlink Ems Inc | Ambulance | 6825 Jimmy Carter Blvd Ste 1303, Norcross, GA 30071 | 2017-12-19 |
| 1205377975 | David Kalisz II | Specialist/Technologist, Other | 1880 Beaver Ridge Circle Suite D, Norcross, GA 30071 | 2017-03-15 |
| 1356792519 | Tiffany Pope | Counselor | 6045 Atlantic Blvd Ste 108, Norcross, GA 30071 | 2016-06-28 |
| Find all providers in zip 30071 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919583 | New Haven Senior Care LLC | In Home Supportive Care | 2810 Treehouse Pkwy, Norcross, GA 30093-3484 | 2020-07-09 |
| 1376005900 | Leonard Anthony Campbell | In Home Supportive Care | 1202 Treetrail Pkwy, Norcross, GA 30093-2549 | 2019-04-02 |
| 1861984783 | Isilda Isaza | In Home Supportive Care | 6045 Atlantic Blvd Ste 204, Norcross, GA 30071-1322 | 2018-06-06 |
| 1225497787 | Restorative Home Care | In Home Supportive Care | 7088 Murphy Joy Ln Nw, Norcross, GA 30092-6651 | 2016-02-12 |
| 1548634488 | Homecare Angels | In Home Supportive Care | 2820 Simpson Cir, Norcross, GA 30071-2824 | 2015-11-16 |
| 1043680267 | Gaddiel Services | In Home Supportive Care | 807 Sparrows Ln, Norcross, GA 30093-5517 | 2015-09-30 |
| 1356775803 | Tonti Enterprise LLC | In Home Supportive Care | 1 Meca Way Bldg E, Norcross, GA 30093-2919 | 2013-09-02 |
| 1760816813 | Ohana Group, LLC | In Home Supportive Care | 4124 Steve Reynolds Blvd, Norcross, GA 30093-3059 | 2013-08-26 |
| 1275838070 | Sencare Services LLC | In Home Supportive Care | 3853 Rainforest Cir, Norcross, GA 30092-2347 | 2011-01-26 |
| 1134425960 | Lloyd Heathcare, LLC | In Home Supportive Care | 3845 Holcomb Bridge Rd, Suite 400, Norcross, GA 30092-5251 | 2011-01-26 |
| Find all providers in NORCROSS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.