Organization · NPI-2
Clinical Intervention Specialists
Community/Behavioral Health · Mableton, GA
NPI number1164677159
StatusActive
Last updated in NPPESNov 18, 2008
Details
- NPI
- 1164677159
- Entity type
- Organization (NPI-2)
- Legal business name
- Clinical Intervention Specialists
- Organization subpart
- No
- Enumeration date
- Nov 18, 2008
- Last updated
- Nov 18, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
6859 Slate Stone Way SeMableton, GA 30126-5469
Phone 770-745-3556 · Fax 770-745-6903
Mailing address
696 Mount Zion RdSuite 9-C
Jonesboro, GA 30236-1597
Phone 678-802-1970
Authorized official
Loutina Rena Murrell
Executive Director
6784220723
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