Provider Demographics
NPI:1366820276
Name:ADVANCED HEARING, LLC
Entity Type:Organization
Organization Name:ADVANCED HEARING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNETTE
Authorized Official - Middle Name:ELISABETH
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-508-6832
Mailing Address - Street 1:5673 PEACHTREE DUNWOODY ROAD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-297-4230
Mailing Address - Fax:404-252-7255
Practice Address - Street 1:5673 PEACHTREE DUNWOODY RD
Practice Address - Street 2:SUITE 150
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1731
Practice Address - Country:US
Practice Address - Phone:404-297-4230
Practice Address - Fax:404-252-7255
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENT OF GEORGIA, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003409237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty