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General NPI Number Information
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NPI Number | 1811612385
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Entity Type | Organization
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Legal Business Name | GOLDEN JEWELS REHAB & HEALING, LLC
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Dates
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Enumeration Date | 10/07/2022
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 126 W SOLOMON ST
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City | GRIFFIN
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State | GA
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Zip | 30223-3045
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Country | US
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Telephone | 678-572-4441
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Fax |
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Provider Business Mailing Address
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Address Line | 126 W SOLOMON ST
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City | GRIFFIN
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State | GA
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Zip | 30223-3045
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Country | US
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Telephone | 678-603-5983
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DEANDRE SIMS
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Credential | OTR/L
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Telephone | 404-242-3286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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