Provider Demographics
NPI:1811612385
Name:GOLDEN JEWELS REHAB & HEALING, LLC
Entity type:Organization
Organization Name:GOLDEN JEWELS REHAB & HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:404-242-3286
Mailing Address - Street 1:126 W SOLOMON ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-3045
Mailing Address - Country:US
Mailing Address - Phone:678-603-5983
Mailing Address - Fax:
Practice Address - Street 1:126 W SOLOMON ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-3045
Practice Address - Country:US
Practice Address - Phone:678-572-4441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty