Organization · NPI-2

Capital City Community Services LLC

Community/Behavioral Health · Mableton, GA

NPI number1649652637
StatusActive
Last updated in NPPESMar 23, 2016

Details

NPI
1649652637
Entity type
Organization (NPI-2)
Legal business name
Capital City Community Services LLC
Organization subpart
No
Enumeration date
Jun 25, 2015
Last updated
Mar 23, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health–GAYes
251300000X Local Education Agency (LEA)–GA
251B00000X Case Management–GA

Practice location

5701 Mableton Pkwy
Ste# 102
Mableton, GA 30126-2045

Phone 770-415-7200 · Fax 470-689-0006

Mailing address

5701 Mableton Pkwy
Ste# 102
Mableton, GA 30126-2045

Phone 770-415-7200 · Fax 470-689-0006

Authorized official

Famika Lashell Robertson
Chief Executive Director
7704157200

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