Pediatric Therapies Of Se Ga, Llc

LBN: Pediatric Therapies Of Se Ga, Llc
Pediatric Therapies Of Se Ga, Llc is an health care organization with primary practice located at 4212 Coral Park Dr , Brunswick GA 31520-3016. The organization recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is the primary health care specialty. Pediatric Therapies Of Se Ga, Llc can be contacted via phone (912) 342-8875, or through Parks, Karen Michelle via phone (912) 342-8875.

Contact Information

Primary practice address
4212 Coral Park Dr Brunswick GA 31520-3016
Phone: (912) 342-8875
Fax: (912) 265-0041
Website:
Map and Directions
Authorized official contact:
Name: Parks, Karen Michelle MS, OTR/L
Phone: (912) 342-8875

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT001375 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT002198 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT005680 Georgia
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP001592 Georgia

Profile Details

NPI number 1841577111
LBN Legal business name Pediatric Therapies Of Se Ga, Llc
DBA Doing business as
Authorized official Parks, Karen Michelle MS, OTR/L
Entity Organization
Organization subpart 1 No
Enumeration date Nov 14th, 2011
Last updated Jun 19th, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841577111 NPPES
Georgia MEDICAID 003116394B

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