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General NPI Number Information
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NPI Number | 1952337214
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Entity Type | Organization
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Legal Business Name | STG HEALTHCARE OF ATLANTA, INC.
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 400 INTERSTATE NORTH PKWY SE STE 1250
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City | ATLANTA
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State | GA
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Zip | 30339-7213
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Country | US
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Telephone | 404-843-2708
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Fax | 404-843-1058
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Provider Business Mailing Address
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Address Line | 400 INTERSTATE NORTH PKWY SE STE 1250
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City | ATLANTA
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State | GA
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Zip | 30339-7213
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Country | US
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Telephone | 404-843-2708
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Fax | 404-843-1058
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Authorized Official
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Title or Position | CFO
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Name | MR. MATHEW GILLEY
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Credential |
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Telephone | 404-843-2708
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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 | 060291H
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License Number State | GA
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