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General NPI Number Information
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NPI Number | 1063564722
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Entity Type | Organization
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Legal Business Name | GEORGIA PARENT SUPPORT NETWORK, INC.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1395 METROPOLITAN PKWY SW
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City | ATLANTA
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State | GA
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Zip | 30310-4455
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Country | US
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Telephone | 404-756-8525
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Fax |
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Provider Business Mailing Address
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Address Line | 1381 METROPOLITAN PKWY SW
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City | ATLANTA
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State | GA
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Zip | 30310-4455
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Country | US
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Telephone | 404-758-4500
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Fax |
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Authorized Official
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Title or Position | CO-CEO
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Name | MRS. SUE SMITH
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Credential | PH.D.
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Telephone | 404-758-4500
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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 | 251S00000X
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License Number State | GA
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