MEDICARE: STILL STANDING 2000, INC

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	:	1538229703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STILL STANDING 2000, INC

Provider Business Mailing Address
First Line	:	707 N WASHINGTON ST
Second Line	:
City	:	QUITMAN
State	:	GA
Zip	:	31643-1657
Country	:	US
Telephone Number	:	229-605-9823
Fax Number	:	229-605-9936

Provider Business Practice Location Address
First Line	:	707 N WASHINGTON ST
Second Line	:
City	:	QUITMAN
State	:	GA
Zip	:	31643-1657
Country	:	US
Telephone Number	:	229-605-9823
Fax Number	:	229-605-9936

Authorized Official
Title or Position	:	CEO
Name	:	MRS. NATASHA AIKENS
Credential	:
Telephone Number	:	229-605-9823

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	08/22/2020

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Directions to “STILL STANDING 2000, INC ” Practice Location

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