MEDICARE: RESEARCH COMMUNITY CARE OF GEORGIA LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP1600X	Pastoral Counselor
2	103K00000X	Behavior Analyst
3	104100000X	Social Worker
4	101YM0800X	Mental Health Counselor
5	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1962358663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESEARCH COMMUNITY CARE OF GEORGIA LLC

Provider Business Mailing Address
First Line	:	PO BOX 13721
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27709-3721
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 POWERS FERRY RD SE STE 200
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-5491
Country	:	US
Telephone Number	:	919-706-7160
Fax Number	:

Authorized Official
Title or Position	:	ORGANIZING MEMBER
Name	:	SHAKEEMA PRIESTER
Credential	:
Telephone Number	:	919-225-9447

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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