Children & Adult Therapy Services
Organization Active NPI Rehabilitation Practitioner · Monroe, GA
NPI 1295738540 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1295738540
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Practitioner 225400000X
- License
- 116745 (GA)
- Legal business name
- CHILDREN & ADULT THERAPY SERVICES
- Practice address
- 226 Alcovy St
Ste G-1
Monroe, GA 30655-2183 - Phone
- (770) 207-9043
- Fax
- (770) 207-9029
- NPI assigned
- May 31, 2005
- Organization subpart
- No
Authorized official
- Name
- Ruth Ellen Roberts, SLP
- Title
- Owner
- Phone
- (770) 207-9043
Practitioners 3
-
Ruth Ellen Roberts, MACCCSLP
-
David Bruce Bollinger, OTR/L
-
Lisette Hernandez, SLP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240111000689 | GA | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 0941455059 |
Receives reassigned benefits from 1 practitioner Practice locations: Monroe, GA |
National Provider Directory
Locations
226 Alcovy St
Ste G1
Monroe, GA 30655
Phone (770) 207-9043
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner |
225400000X | 116745 | GA | Yes |
Addresses
Primary practice location
226 Alcovy St
Ste G-1
Monroe, GA 30655-2183
Mailing address
226 Alcovy St
Ste G-1
Monroe, GA 30655-2183
Phone (770) 207-9043
Other providers in Monroe, GA
- Center for Medical Resources, Inc
- Samuel Chang
- Leyla Tasmaz Chenevey
- Rosemary Chickos
- Child & Family Therapy Solutions, Inc.
- Terry Supanee Chongulia
- Shannon Christian
- Chronic Disease Management of Georgia, LLC
- Circle of Care, Inc
- Pamela R. Clack
All providers in Monroe, GA · Rehabilitation Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.