MEDICARE: COMMUNITY OUTREACH FOR YOUTH & FAMILY SERVICES OF GA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1083892798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY OUTREACH FOR YOUTH & FAMILY SERVICES OF GA

Provider Business Mailing Address
First Line	:	1514 CLEVELAND AVE
Second Line	:	SUITE 120
City	:	EAST POINT
State	:	GA
Zip	:	30344-6965
Country	:	US
Telephone Number	:	919-423-2277
Fax Number	:

Provider Business Practice Location Address
First Line	:	1514 CLEVELAND AVE
Second Line	:	SUITE 120
City	:	EAST POINT
State	:	GA
Zip	:	30344-6965
Country	:	US
Telephone Number	:	919-423-2277
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. CORY TITO FRANCIS
Credential	:
Telephone Number	:	919-423-2277

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	10/23/2014

Similar Medicare Providers

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Practice Location Address:

1514 CLEVELAND AVE STE 205
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1417172578 — DR. GWENETH MARTIN HAYES PH.D.
Practice Location Address:

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1205091279 — LULA GILLIAM & ASSOCIATES, INC
Practice Location Address:

1514 EAST CLEVELAND AVE , SUITE 99-A
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30344-6965

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1811269442 — MRS. WALLENDA BROOKE TERRELL M.ED.,CCC-SLP
Practice Location Address:

1514 CLEVELAND AVE STE 101B
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1912246406 — AMERICAN FAMILY CARE NETWORK OF GEORGIA
Practice Location Address:

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1437522083 — LAUREN WARD
Practice Location Address:

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Practice Fax:

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