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General NPI Number Information
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NPI Number | 1275946451
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Entity Type | Organization
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Legal Business Name | ASSURANCE PROFESSIONAL SERVICES INC
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 1414 MORELAND AVE SE
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City | ATLANTA
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State | GA
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Zip | 30316-3207
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Country | US
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Telephone | 404-627-1774
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Fax | 404-627-1765
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Provider Business Mailing Address
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Address Line | 1414 MORELAND AVE SE
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City | ATLANTA
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State | GA
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Zip | 30316-3207
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Country | US
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Telephone | 404-627-1774
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Fax | 404-627-1765
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Authorized Official
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Title or Position | AGENT
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Name | CLARENCE W MASSIE JR.
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Credential | ICADC, CADC-II
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Telephone | 404-627-1774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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