Provider Demographics
NPI:1235968355
Name:TALK THERAPY HOME HEALTH SERVICE LLC
Entity type:Organization
Organization Name:TALK THERAPY HOME HEALTH SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RASHEEDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:KIMBRO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:678-772-0408
Mailing Address - Street 1:717 S JEFF DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-2416
Mailing Address - Country:US
Mailing Address - Phone:678-772-0408
Mailing Address - Fax:470-758-8853
Practice Address - Street 1:717 S JEFF DAVIS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-2416
Practice Address - Country:US
Practice Address - Phone:678-772-0408
Practice Address - Fax:470-758-8853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health