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General NPI Number Information
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NPI Number | 1326307257
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Entity Type | Organization
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Legal Business Name | A AFFORDABLE DUI SCHOOL LLC
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Dates
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Enumeration Date | 05/12/2012
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Last Update Date | 05/12/2012
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Provider Practice Location Address
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Address Line | 6360 HIGHWAY 85
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City | RIVERDALE
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State | GA
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Zip | 30274-1609
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Country | US
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Telephone | 770-996-9026
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Fax | 770-996-5750
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Provider Business Mailing Address
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Address Line | 6360 HIGHWAY 85
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City | RIVERDALE
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State | GA
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Zip | 30274-1609
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Country | US
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Telephone | 770-996-9026
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Fax | 770-996-5750
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. LORRAINE OLIVER
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Credential | M.ED, CADCII, ICADC
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Telephone | 770-996-9026
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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 | 704020
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 489
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License Number State | GA
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