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General NPI Number Information
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NPI Number | 1407704638
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Entity Type | Organization
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Legal Business Name | EDAC EVERYONE DESERVES A CHANCE
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Dates
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Enumeration Date | 03/21/2026
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Last Update Date | 03/21/2026
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Provider Practice Location Address
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Address Line | 585 SHADOW OAKS DR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-4787
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Country | US
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Telephone | 678-651-5373
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Fax |
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Provider Business Mailing Address
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Address Line | 585 SHADOW OAKS DR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-4787
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Country | US
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Telephone | 678-651-5373
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JILLMARIE STURGEADAMS
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Credential | PHD.
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Telephone | 678-651-5373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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