Healthcare Provider Details

I. General information

NPI: 1780265074
Provider Name (Legal Business Name): FIRST RESPONSE CALL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2890 HIGHWAY 212 SW # 164-A
CONYERS GA
30094-3363
US

IV. Provider business mailing address

2890 HIGHWAY 212 SW # 164-A
CONYERS GA
30094-3363
US

V. Phone/Fax

Practice location:
  • Phone: 404-201-0523
  • Fax:
Mailing address:
  • Phone: 404-201-0523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CHAREKA CROSS
Title or Position: CEO
Credential:
Phone: 404-201-0523