Provider Demographics
NPI:1326352402
Name:FAMILIES MATTER THERAPIES, LLC
Entity Type:Organization
Organization Name:FAMILIES MATTER THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNISSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC/SLP
Authorized Official - Phone:404-606-3755
Mailing Address - Street 1:7162 LONE OAK WAY
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-8291
Mailing Address - Country:US
Mailing Address - Phone:404-606-3755
Mailing Address - Fax:770-696-1065
Practice Address - Street 1:7162 LONE OAK WAY
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-8291
Practice Address - Country:US
Practice Address - Phone:404-606-3755
Practice Address - Fax:770-696-1065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA682990135AMedicaid