| NPI | 1972099737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKEISHA JACKSON Owner 404-939-5976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| 261QH0700X Clinic/Center Hearing and Speech | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2023-10-24 |