Healthcare Provider Details

I. General information

NPI: 1861001752
Provider Name (Legal Business Name): THE BID PROJECT ENTERPRISE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5987 PATTILLO LN
LITHONIA GA
30058-6295
US

IV. Provider business mailing address

5987 PATTILLO LN
LITHONIA GA
30058-6295
US

V. Phone/Fax

Practice location:
  • Phone: 404-702-7853
  • Fax:
Mailing address:
  • Phone: 404-702-7853
  • 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 Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225CX0006X
TaxonomyOrientation and Mobility Training Rehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name: CALVIN COOKS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 404-702-7853