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General NPI Number Information
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NPI Number | 1295159010
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Entity Type | Organization
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Legal Business Name | ONE COMMUNITY BEHAVIORAL SERVICES, LLC
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 3783 PRESIDENTIAL PKWY SUITE 125
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City | ATLANTA
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State | GA
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Zip | 30340-3709
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Country | US
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Telephone | 202-246-7248
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Fax |
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Provider Business Mailing Address
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Address Line | 3783 PRESIDENTIAL PKWY SUITE 125
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City | ATLANTA
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State | GA
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Zip | 30340-3709
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Country | US
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Telephone | 202-246-7248
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. ADIB S SHAKIR
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Credential | ED.S
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Telephone | 202-246-7248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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