Healthcare Provider Details

I. General information

NPI: 1689280687
Provider Name (Legal Business Name): THE SOCIAL EXCHANGE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 S LEE ST
AMERICUS GA
31709-3915
US

IV. Provider business mailing address

323 S LEE ST
AMERICUS GA
31709-3915
US

V. Phone/Fax

Practice location:
  • Phone: 844-333-1120
  • Fax: 844-333-1120
Mailing address:
  • Phone: 844-333-1120
  • Fax: 844-333-1120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNULL
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MISS JESSICA S MURRAY
Title or Position: CEO
Credential:
Phone: 844-333-1120