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General NPI Number Information
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NPI Number | 1992065668
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Entity Type | Organization
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Legal Business Name | FAMILIES ADVOCACY FOR VOICES OF RESILIENCE
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 05/29/2012
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Provider Practice Location Address
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Address Line | 798 RAYS RD SUITE 9496
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-3144
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Country | US
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Telephone | 404-499-0078
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Fax |
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Provider Business Mailing Address
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Address Line | 798 RAYS RD SUITE 9496
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-3144
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Country | US
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Telephone | 404-499-0078
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MS. CARMEN COATES
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Credential |
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Telephone | 404-587-8286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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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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