Healthcare Provider Details

I. General information

NPI: 1548698723
Provider Name (Legal Business Name): ES REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2013
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CLIFTON RD NE
ATLANTA GA
30322-1004
US

IV. Provider business mailing address

1441 CLIFTON RD NE
ATLANTA GA
30322-1004
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-5512
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: AVA E DAUNT-SAMFORD
Title or Position: VP/CFO
Credential:
Phone: 404-686-4918