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Organization
MEDI HOME THERAPY LLC
Active
Organization
MEDI HOME THERAPY LLC
Active
Parent organization
MEDI CAREGIVERS
Other names
MEDI CAREGIVERS HOME THERAPY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDI CAREGIVERS
Authorized official
JESSICA LANE (ADMINISTRATOR)
(770) 483-6393
Entity
Organization
Contact information
Practice address
1257 COMMERCIAL DR SW STE B, CONYERS, GA 30094-5991
(770) 483-6393
Mailing address
1257 COMMERCIAL DR SW STE B, CONYERS, GA 30094-5991
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
12/02/2010
Last updated
12/03/2010
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