Healthcare Provider Details

I. General information

NPI: 1821226200
Provider Name (Legal Business Name): SANE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 PLANTATION TRACE DR
DULUTH GA
30096-1600
US

IV. Provider business mailing address

116 PLANTATION TRACE DR
DULUTH GA
30096-1600
US

V. Phone/Fax

Practice location:
  • Phone: 678-744-9567
  • Fax:
Mailing address:
  • Phone: 678-744-9567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: SCARLET ADANA CHATMAN
Title or Position: OWNER
Credential:
Phone: 678-557-3326