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General NPI Number Information
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NPI Number | 1851102453
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Entity Type | Organization
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Legal Business Name | UNITED COMMUNITY SERVICE LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 1047 GREEN ST SE
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City | CONYERS
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State | GA
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Zip | 30012-5450
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Country | US
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Telephone | 404-259-0317
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Fax |
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Provider Business Mailing Address
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Address Line | 151 HARPER RD
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City | MCDONOUGH
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State | GA
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Zip | 30252-8411
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Country | US
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Telephone | 404-259-0317
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BARBARA OLUSESI
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Credential |
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Telephone | 404-259-0317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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