Provider Demographics
NPI:1144766296
Name:EOA SERVICES
Entity Type:Organization
Organization Name:EOA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAURARSA
Authorized Official - Middle Name:CHANEL
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-377-3977
Mailing Address - Street 1:1226 ROYAL DR SW
Mailing Address - Street 2:STE D
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-5925
Mailing Address - Country:US
Mailing Address - Phone:470-377-3977
Mailing Address - Fax:470-443-1736
Practice Address - Street 1:1226 ROYAL DR SW
Practice Address - Street 2:STE D
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5925
Practice Address - Country:US
Practice Address - Phone:470-377-3977
Practice Address - Fax:470-443-1736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health