Provider Demographics
NPI:1467936559
Name:HEALTHY COLLABORATIONS LLC
Entity Type:Organization
Organization Name:HEALTHY COLLABORATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:BARNES
Authorized Official - Last Name:HAMMOCK
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:770-590-0408
Mailing Address - Street 1:3911 MARY ELIZA TRCE NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1086
Mailing Address - Country:US
Mailing Address - Phone:678-384-3480
Mailing Address - Fax:678-384-3481
Practice Address - Street 1:3911 MARY ELIZA TRCE NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1086
Practice Address - Country:US
Practice Address - Phone:678-384-3480
Practice Address - Fax:678-384-3481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty