Organization · NPI-2
Social Services Institute, LLC
Early Intervention Provider Agency · Mableton, GA
NPI number1740535962
StatusActive
Last updated in NPPESJul 14, 2012
Details
- NPI
- 1740535962
- Entity type
- Organization (NPI-2)
- Legal business name
- Social Services Institute, LLC
- Organization subpart
- No
- Enumeration date
- Jul 14, 2012
- Last updated
- Jul 14, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | CSW001776 | GA | Yes |
| 251300000X | Local Education Agency (LEA) | CSW001776 | GA | |
| 251B00000X | Case Management | CSW001776 | GA | |
| 253Z00000X | In Home Supportive Care | CSW001776 | GA |
Practice location
4581 Duron Pl SwMableton, GA 30126-1177
Phone 770-944-7280 · Fax 770-944-7280
Mailing address
Po Box 1821Mableton, GA 30126-1013
Phone 770-944-7280 · Fax 770-944-7280
Authorized official
Henry Earl Roberson
Clinical Director/Owner
7709447280
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