Healthcare Provider Details
I. General information
NPI: 1962199216
Provider Name (Legal Business Name): CAREER ASSOCIATION OF GEORGIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1190 N HIGHLAND AVE NE
ATLANTA GA
30306-4051
US
IV. Provider business mailing address
1441 22ND ST APT B
COLUMBUS GA
31901-1669
US
V. Phone/Fax
- Phone: 678-667-3013
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 177F00000X |
| Taxonomy | Lodging Provider |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIA
LEGETTE
Title or Position: FOUNDER
Credential:
Phone: 678-667-3013