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General NPI Number Information
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NPI Number | 1548530058
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Entity Type | Organization
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Legal Business Name | PERMANENCY STEPS CONSULTING FIRM, LLC
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Dates
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Enumeration Date | 01/01/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 136 HIGHWAY 138 SW SUITE 200
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City | RIVERDALE
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State | GA
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Zip | 30274-4008
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Country | US
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Telephone | 404-323-6198
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Fax | 770-472-7890
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Provider Business Mailing Address
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Address Line | PO BOX 960424
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City | RIVERDALE
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State | GA
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Zip | 30296-0424
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Country | US
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Telephone | 404-323-6198
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Fax | 770-472-7890
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | IVIS RENEE KING
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Credential | MSW
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Telephone | 404-323-6198
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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 | CSW000573
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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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 | 347E00000X
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Taxonomy Name | Transportation Broker
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | CSW000573
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | CSW000573
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License Number State | GA
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