Healthcare Provider Details

I. General information

NPI: 1124984224
Provider Name (Legal Business Name): NEIGHBORHOOD IMPROVEMENT PROJECT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 UNIVERSITY PKWY STE 103
EVANS GA
30809-3093
US

IV. Provider business mailing address

PO BOX 96841
CHARLOTTE NC
28296-6841
US

V. Phone/Fax

Practice location:
  • Phone: 706-790-4440
  • Fax:
Mailing address:
  • Phone: 706-790-4440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: NICHOLE RICHARDS
Title or Position: BILLING SITE SUPERVISOR
Credential: CPC
Phone: 706-434-1353