Healthcare Provider Details

I. General information

NPI: 1730008590
Provider Name (Legal Business Name): HEAVEN'S ARK CHILDREN'S THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7412 CHADS CIR
JONESBORO GA
30236-5703
US

IV. Provider business mailing address

7412 CHADS CIR
JONESBORO GA
30236-5703
US

V. Phone/Fax

Practice location:
  • Phone: 678-365-7189
  • Fax:
Mailing address:
  • Phone: 678-365-7189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA BUTTLER
Title or Position: OWNER/MANAGING MEMBER
Credential: MSOT, OTR/L
Phone: 678-365-7189