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General NPI Number Information
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NPI Number | 1902288541
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Entity Type | Organization
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Legal Business Name | ATLANTA HEALTH AND INJURY CLINIC INC.
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Dates
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Enumeration Date | 06/19/2015
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 550 FAIRBURN RD SW STE A5
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City | ATLANTA
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State | GA
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Zip | 30331-2015
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Country | US
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Telephone | 404-691-4822
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Fax | 404-692-4144
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Provider Business Mailing Address
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Address Line | 550 FAIRBURN RD SW STE A5
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City | ATLANTA
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State | GA
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Zip | 30331-2015
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Country | US
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Telephone | 404-691-4822
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Fax | 404-692-4144
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Authorized Official
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Title or Position | CEO
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Name | MR. ORIE TRAVOY JENKINS
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Credential | ADMINISTRATOR
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Telephone | 404-229-6222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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