| NPI | 1578191847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN KEELING Organizer 678-697-2932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 251E00000X Home Health |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 385HR2050X Respite Care, Respite Care Camp | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-03-31 |