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General NPI Number Information
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NPI Number | 1922403500
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Entity Type | Organization
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Legal Business Name | COORDINATION SERVICES OF ATLANTA INC.
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Dates
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Enumeration Date | 10/25/2014
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Last Update Date | 10/25/2014
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Provider Practice Location Address
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Address Line | 207 MYRTLEWOOD DR
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City | MONTEZUMA
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State | GA
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Zip | 31063-7233
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Country | US
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Telephone | 229-815-4638
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 531
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City | MONTEZUMA
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State | GA
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Zip | 31063-0531
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Country | US
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Telephone | 229-815-4638
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Fax |
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Authorized Official
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Title or Position | CASE MANAGER/SERVICE COORDINATOR
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Name | MS. SHEILA HAMBRICK
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Credential | MPH
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Telephone | 229-815-4636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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