Healthcare Provider Details

I. General information

NPI: 1992192678
Provider Name (Legal Business Name): GLOBAL CARE CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 04/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 AYERS AVE NE
MARIETTA GA
30060-2112
US

IV. Provider business mailing address

20 AYERS AVE NE
MARIETTA GA
30060-2112
US

V. Phone/Fax

Practice location:
  • Phone: 770-865-9118
  • Fax: 888-341-3210
Mailing address:
  • Phone: 770-865-9118
  • Fax: 888-341-3210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCOO4963
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DR. LAUREL-TITI A IPADEOLA
Title or Position: CEO
Credential: PH.D, LPC
Phone: 770-865-9118