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General NPI Number Information
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NPI Number | 1164356572
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN ADULT SERVICES
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 405 KICHLINE RD
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City | HELLERTOWN
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State | PA
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Zip | 18055-9774
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Country | US
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Telephone | 404-539-5838
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Fax |
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Provider Business Mailing Address
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Address Line | 8735 DUNWOODY PL # 7079
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City | SANDY SPRINGS
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State | GA
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Zip | 30350-2995
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Country | US
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Telephone | 404-539-5838
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANDRIA JONES
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Credential |
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Telephone | 404-539-5838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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 | 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 #4
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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