Provider Demographics
NPI:1275011439
Name:HIGH HOPES CHILDREN'S THERAPY LLC
Entity Type:Organization
Organization Name:HIGH HOPES CHILDREN'S THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-395-3269
Mailing Address - Street 1:6220 LAKEAIRES DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-4292
Mailing Address - Country:US
Mailing Address - Phone:678-395-3269
Mailing Address - Fax:678-807-2567
Practice Address - Street 1:3538 OLD MILTON PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4459
Practice Address - Country:US
Practice Address - Phone:678-395-3269
Practice Address - Fax:678-807-2567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006066225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003176348BMedicaid
GA003176348CMedicaid
GA003199046BMedicaid
GA003185164AMedicaid
GA003202203AMedicaid