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General NPI Number Information
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NPI Number | 1679933501
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD IMPROVEMENT PROJECT
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 811 13TH ST STE 10
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City | AUGUSTA
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State | GA
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Zip | 30901-2700
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Country | US
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Telephone | 706-790-4440
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Fax | 706-790-4393
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Provider Business Mailing Address
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Address Line | 2467 GOLDEN CAMP RD
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City | AUGUSTA
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State | GA
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Zip | 30906-5515
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Country | US
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Telephone | 706-790-4440
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Fax | 706-790-4393
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Authorized Official
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Title or Position | CFO
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Name | WESLEY WOOD
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Credential |
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Telephone | 706-790-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | 032689
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 032689
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 032689
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 032689
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License Number State | GA
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