Provider Demographics
NPI:1275753782
Name:FAMILY TIES INC.
Entity Type:Organization
Organization Name:FAMILY TIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:T
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-460-0345
Mailing Address - Street 1:270 CARPENTER DR NE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4931
Mailing Address - Country:US
Mailing Address - Phone:678-460-0345
Mailing Address - Fax:678-460-0350
Practice Address - Street 1:270 CARPENTER DR NE
Practice Address - Street 2:SUITE 400
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4931
Practice Address - Country:US
Practice Address - Phone:678-460-0345
Practice Address - Fax:678-460-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA538932677AMedicaid