MEDICARE: THERANEEDS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		GA
2	283X00000X	Rehabilitation Hospital		GA

General Provider Information

NPI Number	:	1902872310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERANEEDS, INC

Provider Business Mailing Address
First Line	:	5107 PANOLA MILL DR
Second Line	:
City	:	LITHONIA
State	:	GA
Zip	:	30038-2352
Country	:	US
Telephone Number	:	770-981-4927
Fax Number	:

Provider Business Practice Location Address
First Line	:	5107 PANOLA MILL DR
Second Line	:
City	:	LITHONIA
State	:	GA
Zip	:	30038-2352
Country	:	US
Telephone Number	:	770-981-4927
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	MISS JAVONYA CLEMONS
Credential	:	MS-SLP
Telephone Number	:	770-981-4927

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	09/11/2025

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Directions to “THERANEEDS, INC ” Practice Location

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