Provider Demographics
NPI:1104431758
Name:CLARA'S HOME HEALTHCARE INSTITUTE
Entity type:Organization
Organization Name:CLARA'S HOME HEALTHCARE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANEKA S
Authorized Official - Middle Name:KENNON
Authorized Official - Last Name:PAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-783-9696
Mailing Address - Street 1:3469 HENLEY ST
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-1758
Mailing Address - Country:US
Mailing Address - Phone:678-783-9696
Mailing Address - Fax:404-390-1242
Practice Address - Street 1:3469 HENLEY ST
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-1758
Practice Address - Country:US
Practice Address - Phone:678-783-9696
Practice Address - Fax:404-390-1242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health