Provider Demographics
NPI:1215370572
Name:FOR KIDS SAKE OF NEWNAN, LLC
Entity Type:Organization
Organization Name:FOR KIDS SAKE OF NEWNAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-778-1741
Mailing Address - Street 1:185 WOODSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-3309
Mailing Address - Country:US
Mailing Address - Phone:770-778-1741
Mailing Address - Fax:
Practice Address - Street 1:185 WOODSTREAM DR
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-3309
Practice Address - Country:US
Practice Address - Phone:770-778-1741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health