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General NPI Number Information
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NPI Number | 1841570561
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Entity Type | Organization
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Legal Business Name | FERROL MENTAL AND MEDICAL SERVICES
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Dates
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Enumeration Date | 08/25/2011
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Last Update Date | 08/25/2011
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Provider Practice Location Address
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Address Line | 398 MEADOWOOD CT
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City | LITHONIA
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State | GA
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Zip | 30038-1442
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Country | US
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Telephone | 404-552-9474
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11
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City | REDAN
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State | GA
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Zip | 30074-0011
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Country | US
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Telephone | 404-552-9474
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KAYLARGE ELOI
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Credential |
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Telephone | 404-552-9474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW004872
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License Number State | GA
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