Healthcare Provider Details

I. General information

NPI: 1215004346
Provider Name (Legal Business Name): POSITIVE SOLUTIONS FAMILY ENRICHMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3114 AUGUSTA TECH DR STE 201
AUGUSTA GA
30906-3347
US

IV. Provider business mailing address

3114 AUGUSTA TECH DR STE 201
AUGUSTA GA
30906-3347
US

V. Phone/Fax

Practice location:
  • Phone: 706-796-9785
  • Fax: 706-796-5279
Mailing address:
  • Phone: 706-796-9785
  • Fax: 706-796-5279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberLPC003330
License Number StateGA

VIII. Authorized Official

Name: GREGORY ALLEN GILYARD
Title or Position: CEO
Credential: LPC
Phone: 706-627-8733