Provider Demographics
NPI:1811221377
Name:AQUA-TOTS SWIM SCHOOLS
Entity Type:Organization
Organization Name:AQUA-TOTS SWIM SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARAHONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-445-7323
Mailing Address - Street 1:103 VICTORIA NORTH CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5439
Mailing Address - Country:US
Mailing Address - Phone:678-445-7323
Mailing Address - Fax:678-331-8024
Practice Address - Street 1:103 VICTORIA NORTH CT
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5439
Practice Address - Country:US
Practice Address - Phone:678-445-7323
Practice Address - Fax:678-331-8024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA30280305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service