Provider Demographics
NPI:1104527944
Name:OUR HOUSE, INC.
Entity type:Organization
Organization Name:OUR HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYESE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-522-6056
Mailing Address - Street 1:173 BOULEVARD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1468
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:404-522-6170
Practice Address - Street 1:173 BOULEVARD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1468
Practice Address - Country:US
Practice Address - Phone:404-658-1500
Practice Address - Fax:404-522-6170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center