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General NPI Number Information
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NPI Number | 1154128734
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Entity Type | Organization
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Legal Business Name | SHIELDS FOUNDATION GEORGIA LLC
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 260 PEACHTREE ST NW STE 2200
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City | ATLANTA
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State | GA
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Zip | 30303-1292
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Country | US
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Telephone | 720-746-9254
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Fax |
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Provider Business Mailing Address
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Address Line | 2253 S ONEIDA ST STE 201
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City | DENVER
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State | CO
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Zip | 80224-2562
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Country | US
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Telephone | 720-746-9254
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | ROBERT PLOWDEN
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Credential |
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Telephone | 720-746-9254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 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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