Healthcare Provider Details

I. General information

NPI: 1942712864
Provider Name (Legal Business Name): EINSTEINS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 11/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 HEWATT RD
SNELLVILLE GA
30039-4021
US

IV. Provider business mailing address

2236 HEWATT RD
SNELLVILLE GA
30039-4021
US

V. Phone/Fax

Practice location:
  • Phone: 678-644-3465
  • Fax:
Mailing address:
  • Phone: 678-644-3465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. YOMI OKANLAWON
Title or Position: ADMINISTRATOR
Credential:
Phone: 678-644-3465