Organization
MSK HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYUM MEHDEWI MOHEBI (ADMINISTRATOR)
(770) 235-6160
Entity
Organization
Contact information
Practice address
6515 INDIAN ACRES TRL, TUCKER, GA 30084-1617
(770) 235-6160
Mailing address
6515 INDIAN ACRES TRL, TUCKER, GA 30084-1617
(770) 235-6160
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
02/18/2022
Last updated
02/18/2022
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