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General NPI Number Information
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NPI Number | 1851110050
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Entity Type | Organization
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Legal Business Name | ALTITUDE ACADEMY
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 13 EDDIE HOLMES COURT
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City | SAINT HELENA ISLAND
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State | SC
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Zip | 29920
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Country | US
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Telephone | 404-901-8788
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Fax |
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Provider Business Mailing Address
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Address Line | 13 EDDIE HOLMES COURT
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City | SAINT HELENA ISLAND
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State | SC
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Zip | 29920
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Country | US
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Telephone | 404-901-8788
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. HARRISTON HOLMES JR.
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Credential |
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Telephone | 404-901-8788
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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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