Provider Demographics
NPI:1659521730
Name:INTEGRATED REHABILITATION SPECIALISTS, INC.
Entity Type:Organization
Organization Name:INTEGRATED REHABILITATION SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELHIMER
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:404-838-0942
Mailing Address - Street 1:503 AZALEA CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-4426
Mailing Address - Country:US
Mailing Address - Phone:404-838-0942
Mailing Address - Fax:866-246-7358
Practice Address - Street 1:503 AZALEA CT
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4426
Practice Address - Country:US
Practice Address - Phone:404-838-0942
Practice Address - Fax:866-246-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005492235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA045348007CMedicaid