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General NPI Number Information
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NPI Number | 1205230307
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Entity Type | Organization
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Legal Business Name | THE VILLAGE HEALTH INITIATIVE
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 1890 DETROIT AVE NW
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City | ATLANTA
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State | GA
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Zip | 30314-1638
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Country | US
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Telephone | 404-671-4920
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Fax |
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Provider Business Mailing Address
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Address Line | 750 GLENWOOD AVE SE
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City | ATLANTA
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State | GA
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Zip | 30316-1867
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Country | US
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Telephone | 404-671-4920
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GILES LEEPER
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Credential |
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Telephone | 404-671-4920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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