Provider Demographics
NPI:1134667587
Name:THERAPEUTIC MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:THERAPEUTIC MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TASCHOVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-918-8791
Mailing Address - Street 1:3196 MOUNT ZION RD
Mailing Address - Street 2:#3902
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9304
Mailing Address - Country:US
Mailing Address - Phone:404-382-7421
Mailing Address - Fax:855-441-1607
Practice Address - Street 1:123 E ATLANTA RD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3418
Practice Address - Country:US
Practice Address - Phone:404-382-7421
Practice Address - Fax:855-441-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008917251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health