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General NPI Number Information
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NPI Number | 1376787499
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Entity Type | Organization
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Legal Business Name | POSITIVE CHOICE...A STEP IN THE RIGHT DIRECTION
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Dates
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Enumeration Date | 04/21/2009
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 480 FORREST DR
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City | LOUISVILLE
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State | GA
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Zip | 30434-1348
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Country | US
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Telephone | 706-951-0234
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Fax | 478-625-8974
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Provider Business Mailing Address
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Address Line | 480 FORREST DR
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City | LOUISVILLE
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State | GA
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Zip | 30434-1348
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Country | US
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Telephone | 706-951-0234
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Fax | 478-625-8974
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MS. TARA SHEKERA COMBS
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Credential |
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Telephone | 706-951-0234
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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 |
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License Number State |
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