NPI 1528371663

Heritage Healthcare

Organisation Physical Disabilities Residential Treatment Facility Austell, GA

Practice location

Address: 3829 Floyd Rd, Austell, GA 30106-8534
Phone: (770) 573-2592
Mailing address: 1539 Anna Ruby Ln NW, Kennesaw, GA 30152-8205

Authorised official

Name: Shondre Clemons
Title: Speech Pathologist
Phone: (334) 322-5793

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence SLP006951 (GA)

Other Residential Treatment Facility, Physical Disabilities providers in Georgia →

Registry record

NPI: 1528371663
Entity type: Organization
NPI issued: 19 Jul 2010
Record last updated: 19 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.