Healthcare Provider Details

I. General information

NPI: 1205688660
Provider Name (Legal Business Name): NEIGHBORHOOD IMPROVEMENT PROJECT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 WALTON WAY
AUGUSTA GA
30904-3763
US

IV. Provider business mailing address

PO BOX 63169
CHARLOTTE NC
28263-3169
US

V. Phone/Fax

Practice location:
  • Phone: 706-790-4440
  • Fax:
Mailing address:
  • Phone: 866-770-4104
  • Fax: 706-790-4393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WESLEY WOOD
Title or Position: CFO
Credential:
Phone: 706-790-4440