Organization
CORE INDEPENDENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA NAGY OT (OWNER)
(954) 816-3130
Entity
Organization
Contact information
Practice address
4150 GEORGE BUSBEE PKWY NW, KENNESAW, GA 30144-0800
(678) 206-6201
Mailing address
7220 SCOTSHIRE WAY, CUMMING, GA 30040-7396
(954) 816-3130
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT005325
GA
2251P0200X
Pediatric Physical Therapist
—
GA
225X00000X
Occupational Therapist
OT005289
GA
235Z00000X
Speech-Language Pathologist
—
GA
310400000X
Assisted Living Facility
OT005289
GA
314000000X
Skilled Nursing Facility
OT005289
GA
Other
Enumeration date
03/24/2014
Last updated
04/28/2016
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