Provider Demographics
NPI:1073221297
Name:YOUNG PROFESSIONAL CONSULTING LLC
Entity Type:Organization
Organization Name:YOUNG PROFESSIONAL CONSULTING LLC
Other - Org Name:CAREINTEGRA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-909-9035
Mailing Address - Street 1:1450 W PEACHTREE ST. NW 200
Mailing Address - Street 2:UNITE 25349
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309
Mailing Address - Country:US
Mailing Address - Phone:678-909-9035
Mailing Address - Fax:
Practice Address - Street 1:3100 FIVE FORKS TRICKUM RD SW STE 503
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-1888
Practice Address - Country:US
Practice Address - Phone:678-909-9035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty