Healthcare Provider Details

I. General information

NPI: 1073027520
Provider Name (Legal Business Name): BUSINESS TALENT SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4474 N ROYAL ATLANTA DRIVE SUITE A
TUCKER GA
30084-3008
US

IV. Provider business mailing address

4744 N ROYAL ATLANTA DR
TUCKER GA
30084-3820
US

V. Phone/Fax

Practice location:
  • Phone: 678-671-9594
  • Fax:
Mailing address:
  • Phone: 678-671-9594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHATRECE JENKINS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 678-671-9594