Provider Demographics
NPI:1104248889
Name:REHAB MED CARE, ATLANTA LLC
Entity type:Organization
Organization Name:REHAB MED CARE, ATLANTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GUIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AYERAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:832-228-5331
Mailing Address - Street 1:706 WINDY HILL RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-1855
Mailing Address - Country:US
Mailing Address - Phone:832-228-5331
Mailing Address - Fax:
Practice Address - Street 1:706 WINDY HILL RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-1855
Practice Address - Country:US
Practice Address - Phone:832-228-5331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20213935068261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service