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General NPI Number Information
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NPI Number | 1164349981
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Entity Type | Organization
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Legal Business Name | RAINBOW AUTISM CENTERS OF GEORGIA, LLC
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 5635 PEACHTREE PKWY
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City | NORCROSS
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State | GA
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Zip | 30092-2879
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Country | US
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Telephone | 803-331-2571
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Fax |
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Provider Business Mailing Address
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Address Line | 2379 GLENMORE LN
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City | SNELLVILLE
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State | GA
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Zip | 30078-5679
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Country | US
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Telephone | 803-331-2571
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DAMON KEITH MASSEY
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Credential |
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Telephone | 404-578-9641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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