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General NPI Number Information
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NPI Number | 1639862576
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Entity Type | Organization
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Legal Business Name | ADAPTABLE CLINICAL SOLUTIONS LLC
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 2586 WILLOW GROVE RD NW
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City | ACWORTH
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State | GA
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Zip | 30101-3030
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Country | US
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Telephone | 470-424-2818
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Fax |
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Provider Business Mailing Address
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Address Line | 2586 WILLOW GROVE RD NW
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City | ACWORTH
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State | GA
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Zip | 30101-3030
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Country | US
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Telephone | 470-424-2818
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHEYENNE DOSS
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Credential | LPN
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Telephone | 470-424-2818
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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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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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