Provider Demographics
NPI:1346610276
Name:PRECIOUS MINDS ACADEMY, LLC
Entity Type:Organization
Organization Name:PRECIOUS MINDS ACADEMY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LASHONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LACOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-755-1644
Mailing Address - Street 1:PO BOX 904
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-1053
Mailing Address - Country:US
Mailing Address - Phone:770-755-1644
Mailing Address - Fax:888-789-5431
Practice Address - Street 1:647 S GORDON RD SW
Practice Address - Street 2:SUITE E
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-5138
Practice Address - Country:US
Practice Address - Phone:770-755-1644
Practice Address - Fax:888-789-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty