Healthcare Provider Details

I. General information

NPI: 1326958174
Provider Name (Legal Business Name): NEXT LEVEL COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 PINE LOG RD NE STE 1
CONYERS GA
30012-4747
US

IV. Provider business mailing address

1520 PINE LOG RD NE STE 1
CONYERS GA
30012-4747
US

V. Phone/Fax

Practice location:
  • Phone: 943-216-5690
  • Fax:
Mailing address:
  • Phone: 943-216-5690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. VICKI LAVERNE ELMORECASTEAL
Title or Position: EXECUTIVE DIRECTOR
Credential: BS, MED
Phone: 943-216-5690