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Contact Information

BLACK'S PEDIATRIC THERAPY, INC.
4502 SUMMER GATE CT.
GAINESVILLE, GA30506
 Phone: 770-378-5986
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for BLACK'S PEDIATRIC THERAPY, INC.

NPI # 1477754067
LBN Legal business name BLACK'S PEDIATRIC THERAPY, INC.
Authorized official TINA BLACK - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/30/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
GA License # 003199
GA Other 10038361 AMERIGROUP- TINA
GA Other 10047944 AMERIGROUP-BETH CHAMBERS
GA Other 307327 TINA- WELLCARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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