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General NPI Number Information
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NPI Number | 1245695097
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Entity Type | Organization
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Legal Business Name | CENTER BEYOND SOLUTIONS, LLC
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 300 W I PKWY SUITE 203
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City | DALLAS
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State | GA
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Zip | 30132-5079
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Country | US
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Telephone | 470-888-1832
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W I PKWY SUITE 203
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City | DALLAS
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State | GA
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Zip | 30132-5079
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Country | US
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Telephone | 470-888-1832
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. DEMETRICE WAY HERNDON
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Credential | CADCII
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Telephone | 470-888-1832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | GA
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