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General NPI Number Information
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NPI Number | 1326384165
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Entity Type | Organization
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Legal Business Name | SUCCESSFUL DREAMS BELIEFS & ACHIEVEMENTS, INC.
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Dates
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Enumeration Date | 12/26/2012
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 277 ERMINES WAY
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City | MCDONOUGH
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State | GA
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Zip | 30253-7485
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Country | US
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Telephone | 404-563-9746
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Fax |
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Provider Business Mailing Address
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Address Line | 277 ERMINES WAY
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City | MCDONOUGH
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State | GA
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Zip | 30253-7485
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHAWONNICA S. HIGHTOWER
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Credential |
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Telephone | 404-563-9746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 29622
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 29622
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 29622
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 29622
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License Number State | GA
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