Organization Name: | SOUTHERN THERAPY ASSOCIATES |
NPI Number: | 1013253376 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TASHA S WEST (COTA/L OWNER) |
Mailing Address: | 19350 Hartford St Edison |
State: | GA US |
Postal Code: | 398465617 |
Phone Number: | 2293590741 |
Fax Number: | 2298352119 |
NPI Enumeration Date: | 12/13/2012 |
NPI Last Update Date: | 12/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0401X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Taxonomy Definition: |