Provider Demographics
NPI:1568906956
Name:WESTON GROUP
Entity Type:Organization
Organization Name:WESTON GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:OLAKEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLARINDE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:612-242-9639
Mailing Address - Street 1:194 HUNNICUTT ST NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30313-2144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:194 HUNNICUTT ST NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30313-2144
Practice Address - Country:US
Practice Address - Phone:612-242-9639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006390310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility