Provider Demographics
NPI:1366550204
Name:SENIOR HEALTHCARE SOLUTIONS OF ATLANTA
Entity type:Organization
Organization Name:SENIOR HEALTHCARE SOLUTIONS OF ATLANTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:404-323-1807
Mailing Address - Street 1:1054 EDEN AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-2575
Mailing Address - Country:US
Mailing Address - Phone:404-323-1807
Mailing Address - Fax:866-885-6381
Practice Address - Street 1:925 GARRETT ST SE
Practice Address - Street 2:SUITE 313
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-6826
Practice Address - Country:US
Practice Address - Phone:404-323-1807
Practice Address - Fax:866-885-6381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN145506363LG0600X
GARN151417363LG0600X
GARN 158648363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADC9993OtherRR MEDICARE GRP
GAGRP6992OtherMEDICARE GROUP