Healthcare Provider Details

I. General information

NPI: 1205138864
Provider Name (Legal Business Name): SPECIAL TRANSITION WORKS , LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2010
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11340 LAKEFIELD DR STE 200
JOHNS CREEK GA
30097-2456
US

IV. Provider business mailing address

2100 RIVERSIDE PKWY STE 128-144
LAWRENCEVILLE GA
30043-5927
US

V. Phone/Fax

Practice location:
  • Phone: 800-331-8604
  • Fax: 800-331-8604
Mailing address:
  • Phone: 786-541-6212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. NYMPHA JAMIE MEADOWS
Title or Position: PRINCIPLE OWNER
Credential: M.ED, BCBA
Phone: 800-331-8604