Organization
EDUCATION PLAYSTATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEGAN ELIZABETH MINGONE M.S., CCC-SLP (CEO/OWNER)
(770) 877-9105
Entity
Organization
Contact information
Practice address
127 SUMMER ST, ADAIRSVILLE, GA 30103-2956
(770) 877-9105
(770) 877-9106
Mailing address
127 SUMMER ST, ADAIRSVILLE, GA 30103-2956
(770) 877-9105
(770) 877-9106
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
11-6874
GA
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
11-6874
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000708463E
—
GA
05
—
012454464B
—
GA
05
—
385626610C
—
GA
05
—
478159310B
—
GA
Enumeration date
09/25/2007
Last updated
02/01/2011
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