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NPI 1699097634

NPI 1699097634 : 1ST PRIORITY FAMILY SERVICES : EAST POINT, GA

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General NPI Number Information
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    NPI Number           |    1699097634
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    Entity Type          |    Organization 
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    Legal Business Name  |    1ST PRIORITY FAMILY SERVICES 
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Dates
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    Enumeration Date     |    02/18/2010
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    Last Update Date     |    02/18/2010
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Provider Practice Location Address
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    Address Line         |    2465 MAIN ST 
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    City                 |    EAST POINT
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    State                |    GA
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    Zip                  |    30344-2676
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    Country              |    US
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    Telephone            |    704-913-4239
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1122 
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    City                 |    GASTONIA
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    State                |    NC
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    Zip                  |    28053-1122
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    Country              |    US
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    Telephone            |    704-913-4239
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MR. LARRY A DAVIS 
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    Credential           |    QP
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    Telephone            |    704-913-4239
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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       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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