Allen Therapeutics, LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

713864 Issued in GA

Legal business name

ALLEN THERAPEUTICS, LLC

Practice address

5604 Village Pkwy
Union City, GA 30291-6102

Phone

(770) 964-0142

NPI assigned

Mar 19, 2008

Last updated

Mar 19, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Racquel Sarita Allen, SLP-CCC

Title

Owner

Phone

(404) 403-0250

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1679744528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 VILLAGE PKWY",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302916102",
            "telephone_number": "770-964-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 VILLAGE PKWY",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302916102",
            "telephone_number": "770-964-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEN THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "RACQUEL",
        "authorized_official_middle_name": "SARITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-403-0250",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "SLP-CCC"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "GA",
            "license": "713864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Union City, GA
• Providers in Union City, GA by specialty
• Early Intervention Provider Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.