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General NPI Number Information
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NPI Number | 1255594974
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Entity Type | Organization
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Legal Business Name | BUTTON UP AMERICA LLC
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 450 OLD PEACHTREE ROAD SUITE 101
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City | SUWANEE
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State | GA
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Zip | 30042
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Country | US
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Telephone | 770-895-6043
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Fax |
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Provider Business Mailing Address
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Address Line | 450 OLD PEACHTREE ROAD SUITE 101
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City | SUWANEE
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State | GA
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Zip | 30042
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Country | US
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Telephone | 770-895-6043
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VICTORIA KENNEDY PAUL-EDOUARD
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Credential |
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Telephone | 516-303-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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