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General NPI Number Information
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NPI Number | 1376859769
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Entity Type | Organization
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Legal Business Name | FULL CIRCLE MENTORING AGENCY, INC
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 3275 WARD DR SW
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City | ATLANTA
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State | GA
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Zip | 30354-2641
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Country | US
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Telephone | 404-451-6013
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Fax |
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Provider Business Mailing Address
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Address Line | 3275 WARD DR SW
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City | ATLANTA
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State | GA
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Zip | 30354-2641
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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 | CEO/FOUNDER
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Name | MS. SCHULLAR ROBINSON
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Credential |
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Telephone | 404-451-6013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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