Heritage Healthcare
Residential Treatment Facility, Physical Disabilities in Austell, GA. Organization (NPI-2).
NPI number1528371663
StatusActive
Last updated in NPPESJul 19, 2010
Details
- NPI
- 1528371663
- Entity type
- Organization (NPI-2)
- Legal business name
- Heritage Healthcare
- Organization subpart
- No
- Enumeration date
- Jul 19, 2010
- Last updated
- Jul 19, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320700000X | Residential Treatment Facility, Physical Disabilities | SLP006951 | GA | Yes |
Practice location
3829 Floyd RdAustell, GA 30106-8534
Phone 770-573-2592
Mailing address
1539 Anna Ruby Ln NwKennesaw, GA 30152-8205
Authorized official
Shondre Clemons
Speech Pathologist
3343225793
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