Provider Demographics
NPI:1780187781
Name:ATLANTA REHABILITATION AND PERFORMANCE CENTER, INC
Entity Type:Organization
Organization Name:ATLANTA REHABILITATION AND PERFORMANCE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-982-0102
Mailing Address - Street 1:2400 WISTERIA DR STE A
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2689
Mailing Address - Country:US
Mailing Address - Phone:770-982-0102
Mailing Address - Fax:770-982-0130
Practice Address - Street 1:2920 RONALD REAGAN BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7578
Practice Address - Country:US
Practice Address - Phone:770-887-0502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTA REHABILITATION AND PERFORMANCE CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-15
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty