=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104783414
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE CHILDREN'S LEARNING HUB, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2026
-----------------------------------------------------
Last Update Date | 01/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4129 CORINTH CHURCH RD
-----------------------------------------------------
City | LAKE PARK
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31636-2921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-464-2608
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4129 CORINTH CHURCH RD
-----------------------------------------------------
City | LAKE PARK
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31636-2921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-464-2608
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINIC DIRECTOR
-----------------------------------------------------
Name | MS. CHELSEA WILLIAMS
-----------------------------------------------------
Credential | ED.S.
-----------------------------------------------------
Telephone | 229-464-2608
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QD1600X
-----------------------------------------------------
Taxonomy Name | Developmental Disabilities Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------