Healthcare Provider Details

I. General information

NPI: 1639901176
Provider Name (Legal Business Name): NEIGHBORHOOD IMPROVEMENT PROJECT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 W HILL ST
THOMSON GA
30824-2117
US

IV. Provider business mailing address

PO BOX 780
THOMSON GA
30824-0780
US

V. Phone/Fax

Practice location:
  • Phone: 706-790-4440
  • Fax:
Mailing address:
  • Phone: 706-434-1353
  • Fax: 706-737-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WESLEY WOOD
Title or Position: CFO
Credential:
Phone: 706-790-4440