Provider Demographics
NPI:1205698925
Name:TELEMEDICINE ESSENTIALS OF AMERICA, LLC
Entity type:Organization
Organization Name:TELEMEDICINE ESSENTIALS OF AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TINEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, DNP
Authorized Official - Phone:404-793-4519
Mailing Address - Street 1:1100 PEACHTREE ST NE STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4829
Mailing Address - Country:US
Mailing Address - Phone:404-637-5803
Mailing Address - Fax:888-470-1212
Practice Address - Street 1:1100 PEACHTREE ST NE STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-4829
Practice Address - Country:US
Practice Address - Phone:404-637-5803
Practice Address - Fax:888-470-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit