Provider Demographics
NPI:1225427537
Name:CARE COUNSELING OF GEORGIA
Entity Type:Organization
Organization Name:CARE COUNSELING OF GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBALI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-991-0494
Mailing Address - Street 1:76 MILLENNIUM CIR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-2775
Mailing Address - Country:US
Mailing Address - Phone:706-935-5000
Mailing Address - Fax:706-410-2273
Practice Address - Street 1:76 MILLENNIUM CIR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2775
Practice Address - Country:US
Practice Address - Phone:706-935-5000
Practice Address - Fax:706-410-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005328101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA298979748AMedicaid