Provider Demographics
NPI:1205017043
Name:PEAK DEVELOPMENT GROUP, INC.
Entity Type:Organization
Organization Name:PEAK DEVELOPMENT GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARCELLA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:TRIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-992-5125
Mailing Address - Street 1:3300 BUCKEYE RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4229
Mailing Address - Country:US
Mailing Address - Phone:404-992-5125
Mailing Address - Fax:
Practice Address - Street 1:3300 BUCKEYE RD
Practice Address - Street 2:SUITE 307
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4229
Practice Address - Country:US
Practice Address - Phone:404-992-5125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2011-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003083103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA358167879AMedicaid