=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174710727
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A TOUCH OF EXCELLENCE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/27/2007
-----------------------------------------------------
Last Update Date | 09/27/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1190 LAWYERS LN
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31906-2179
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-322-2121
-----------------------------------------------------
Fax | 706-322-2126
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1190 LAWYERS LN
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31906-2179
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-322-2121
-----------------------------------------------------
Fax | 706-322-2126
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. KEYOKA ADWOA SHIPPMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 706-322-2121
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | 106-R-0024
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 106-R-0024
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------