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General NPI Number Information
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NPI Number | 1043010424
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Entity Type | Organization
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Legal Business Name | HCF PREVENTATIVE SERVICES, INC.
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Dates
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Enumeration Date | 03/15/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 957 MAIN ST
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-3060
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Country | US
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Telephone | 470-336-2149
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Fax |
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Provider Business Mailing Address
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Address Line | 957 MAIN ST STE A-108
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-3060
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Country | US
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Telephone | 470-336-2149
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Fax |
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Authorized Official
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Title or Position | COGNITIVE BEHAVIORAL COACH
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Name | HONIDU MARICO
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Credential | CHW
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Telephone | 470-336-2149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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