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General NPI Number Information
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NPI Number | 1740322635
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Entity Type | Organization
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Legal Business Name | TINAWANE FAMILY SERVICES
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 5090 ALEXANDER AVE
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City | UNION CITY
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State | GA
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Zip | 30291-1140
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Country | US
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Telephone | 404-428-8038
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Fax |
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Provider Business Mailing Address
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Address Line | 5090 ALEXANDER AVE
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City | UNION CITY
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State | GA
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Zip | 30291-1140
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Country | US
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Telephone | 404-428-8038
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RETINA DAWSON-YOUNG
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Credential | MSW
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Telephone | 404-428-8038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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