# 1SOURCE FITNESS & SPORTS NEURO REHAB

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 1SOURCE FITNESS & SPORTS NEURO REHAB
- **Other names:** 1Source Health Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1184174161
- **Legal business name:** 1SOURCE FITNESS & SPORTS NEURO REHAB
- **Authorized official:** COLLIN ADU DPT.GCS. MBA (CLINICAL DIRECTOR)
- **Authorized official phone:** (678) 250-4035

## Contact information

- **Practice address:** 4728 JOSEPH ELI DR, SNELLVILLE, GA 30039-7138
- **Practice address phone:** (678) 257-4037
- **Practice address fax:** (678) 257-4037
- **Mailing address:** 4728 JOSEPH ELI DR, SNELLVILLE, GA 30039-7138
- **Mailing address phone:** (678) 257-4037
- **Mailing address fax:** (678) 257-4037

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 12002969 | GA | Yes |

## Other

- **Enumeration date:** 10/13/2016
- **Last updated:** 10/13/2016