Provider Demographics
NPI:1235711987
Name:BOAT PEOPLE SOS-ATLANTA INC
Entity Type:Organization
Organization Name:BOAT PEOPLE SOS-ATLANTA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRINH
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-458-6700
Mailing Address - Street 1:6107 OAKBROOK PKWY
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1771
Mailing Address - Country:US
Mailing Address - Phone:770-458-6700
Mailing Address - Fax:770-458-6709
Practice Address - Street 1:6107 OAKBROOK PKWY
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-1771
Practice Address - Country:US
Practice Address - Phone:770-458-6700
Practice Address - Fax:770-458-6709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable