Provider Demographics
NPI: | 1528027307 |
---|---|
Name: | SHARE SPEECH, HEARING AND REHAB. ENTERPRISES OF COASTAL GA., INC. |
Entity Type: | Organization |
Organization Name: | SHARE SPEECH, HEARING AND REHAB. ENTERPRISES OF COASTAL GA., INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SECRETARAY |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | GAIL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HATCH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 912-264-3141 |
Mailing Address - Street 1: | 2228 STARLING ST |
Mailing Address - Street 2: | |
Mailing Address - City: | BRUNSWICK |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 31520-4200 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 912-264-3141 |
Mailing Address - Fax: | 913-264-6190 |
Practice Address - Street 1: | 2228 STARLING ST |
Practice Address - Street 2: | |
Practice Address - City: | BRUNSWICK |
Practice Address - State: | GA |
Practice Address - Zip Code: | 31520-4200 |
Practice Address - Country: | US |
Practice Address - Phone: | 912-264-3141 |
Practice Address - Fax: | 913-264-6190 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-03-21 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 174400000X | Other Service Providers | Specialist | Group - Multi-Specialty |