MEDICARE: CHRISTIAN CENTERED EMPOWERMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1427100783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN CENTERED EMPOWERMENT, INC.

Provider Business Mailing Address
First Line	:	PO BOX 370080
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30037-0080
Country	:	US
Telephone Number	:	404-472-7318
Fax Number	:	404-795-8974

Provider Business Practice Location Address
First Line	:	2745 MOUNT ZION RD
Second Line	:	102
City	:	JONESBORO
State	:	GA
Zip	:	30236-6890
Country	:	US
Telephone Number	:	404-472-7318
Fax Number	:	404-795-8974

Authorized Official
Title or Position	:	FOUNDERCEO
Name	:	NICOLE N GUYTON
Credential	:
Telephone Number	:	404-795-8974

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	12/06/2008

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