Provider Demographics
NPI:1346061686
Name:FROM THE HEART GENERATIONAL CARE
Entity type:Organization
Organization Name:FROM THE HEART GENERATIONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMBREIA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-278-6908
Mailing Address - Street 1:957 MAIN ST
Mailing Address - Street 2:STE A #395
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083
Mailing Address - Country:US
Mailing Address - Phone:800-237-0836
Mailing Address - Fax:
Practice Address - Street 1:957 MAIN ST STE A
Practice Address - Street 2:#395
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083
Practice Address - Country:US
Practice Address - Phone:800-237-0836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care