Provider Demographics
NPI:1679973986
Name:THE HUDSON HOUSE, LLC.
Entity type:Organization
Organization Name:THE HUDSON HOUSE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-834-4001
Mailing Address - Street 1:443 BAGWELL RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-9347
Mailing Address - Country:US
Mailing Address - Phone:770-834-4001
Mailing Address - Fax:
Practice Address - Street 1:443 BAGWELL RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-9347
Practice Address - Country:US
Practice Address - Phone:770-834-4001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HUDSON HOUSE, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency