Provider Demographics
NPI:1871100412
Name:FOREVER HARMONY PCH INC
Entity type:Organization
Organization Name:FOREVER HARMONY PCH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TUESDAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-817-2717
Mailing Address - Street 1:205 PROVIDENCE WALK CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8622
Mailing Address - Country:US
Mailing Address - Phone:770-224-8760
Mailing Address - Fax:770-224-8760
Practice Address - Street 1:205 PROVIDENCE WALK CT
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-8622
Practice Address - Country:US
Practice Address - Phone:770-224-8760
Practice Address - Fax:770-224-8760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home