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General NPI Number Information
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NPI Number | 1215247465
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Entity Type | Organization
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Legal Business Name | MILESTONE THERAPY OF GEORGIA, LLC
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 730 CIRRUS DRIVE
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City | ALPHARETTA
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State | GA
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Zip | 30022-7997
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Country | US
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Telephone | 706-955-3000
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Fax | 770-752-7131
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Provider Business Mailing Address
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Address Line | 730 CIRRUS DRIVE
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City | ALPHARETTA
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State | GA
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Zip | 30022-7997
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Country | US
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Telephone | 706-955-3000
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Fax | 770-752-7131
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SUSAN ECKHART
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Credential | CCC-SLP
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Telephone | 706-955-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | SLP006194
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License Number State | GA
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