Provider Demographics
NPI:1225849193
Name:IMPLIED HUMAN DYNAMICS PERSONAL CARE HOME
Entity type:Organization
Organization Name:IMPLIED HUMAN DYNAMICS PERSONAL CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-361-1431
Mailing Address - Street 1:3296 HIGHPOINT CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-7401
Mailing Address - Country:US
Mailing Address - Phone:201-361-1431
Mailing Address - Fax:201-482-2893
Practice Address - Street 1:350 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2270
Practice Address - Country:US
Practice Address - Phone:201-361-1431
Practice Address - Fax:201-482-2893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)