Provider Demographics
NPI:1376103069
Name:DYAD CARE, LLC
Entity Type:Organization
Organization Name:DYAD CARE, LLC
Other - Org Name:DYAD WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ALLIED HEALTH PROFESSIONAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:MCKALE
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, IBCLC
Authorized Official - Phone:229-360-6676
Mailing Address - Street 1:815 CALVIN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BALL GROUND
Mailing Address - State:GA
Mailing Address - Zip Code:30107-1121
Mailing Address - Country:US
Mailing Address - Phone:229-726-7597
Mailing Address - Fax:
Practice Address - Street 1:815 CALVIN PARK DR
Practice Address - Street 2:
Practice Address - City:BALL GROUND
Practice Address - State:GA
Practice Address - Zip Code:30107-1121
Practice Address - Country:US
Practice Address - Phone:229-360-6676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-16
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty