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General NPI Number Information
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NPI Number | 1104429588
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Entity Type | Organization
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Legal Business Name | FAITH AND FAMILY EMPOWERMENT
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 4530 S BERKELEY LAKE RD
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City | BERKELEY LAKE
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State | GA
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Zip | 30071-1660
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Country | US
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Telephone | 678-257-7831
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 CROWN RD SW # 16709
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City | ATLANTA
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State | GA
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Zip | 30304-0001
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Country | US
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Telephone | 678-257-7831
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM HARRIS HEMPHILL II
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Credential | M DIV, LPC
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Telephone | 678-257-7831
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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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