Provider Demographics
NPI:1194481846
Name:CITYVIEWHEALTHCARE
Entity type:Organization
Organization Name:CITYVIEWHEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:EMMANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-895-5880
Mailing Address - Street 1:4006 CARISBROOK DR
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-7127
Mailing Address - Country:US
Mailing Address - Phone:770-895-5880
Mailing Address - Fax:
Practice Address - Street 1:4854 OLD NATIONAL HWY STE 159
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-6248
Practice Address - Country:US
Practice Address - Phone:770-895-5880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care