MEDICARE: HEA THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1689141301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEA THERAPY

Provider Business Mailing Address
First Line	:	2647 ELSINORE ST
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-6723
Country	:	US
Telephone Number	:	678-416-5594
Fax Number	:

Provider Business Practice Location Address
First Line	:	1995 N PARK PL SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-7801
Country	:	US
Telephone Number	:	678-416-5594
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KORI R. LEE
Credential	:	LAPC
Telephone Number	:	678-416-5594

Provider Enumeration Date	:	10/31/2018
Last Update Date	:	10/21/2025

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Directions to “HEA THERAPY ” Practice Location

Language	Start Address	Practice Location

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