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General NPI Number Information
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NPI Number | 1700293636
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Entity Type | Organization
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Legal Business Name | JOURNEY'S FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 6635 ASHEBROOKE DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-5374
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Country | US
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Telephone | 678-713-8433
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Fax |
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Provider Business Mailing Address
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Address Line | 6635 ASHEBROOKE DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-5374
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Country | US
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Telephone | 678-713-8433
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CRYSTAL BESLEY
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Credential |
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Telephone | 678-373-8302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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