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General NPI Number Information
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NPI Number | 1588204374
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Entity Type | Organization
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Legal Business Name | BERRIBIZI LLC
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 41 LENOX POINTE NE STE A
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City | ATLANTA
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State | GA
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Zip | 30324-7424
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Country | US
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Telephone | 470-257-1947
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Fax |
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Provider Business Mailing Address
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Address Line | 41 LENOX POINTE NE STE A
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City | ATLANTA
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State | GA
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Zip | 30324-7424
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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 | ENROLLMENT SPECIALIST
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Name | TISA STANLEY
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Credential |
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Telephone | 770-284-1787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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