Provider Demographics
NPI:1295836369
Name:ALLIANCE FOR CHANGE THROUGH TREATMENT, LLC
Entity Type:Organization
Organization Name:ALLIANCE FOR CHANGE THROUGH TREATMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-406-9707
Mailing Address - Street 1:3524 HABERSHAM AT NORTHLAKE
Mailing Address - Street 2:BLDG. A
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4009
Mailing Address - Country:US
Mailing Address - Phone:678-406-9707
Mailing Address - Fax:678-406-9881
Practice Address - Street 1:3524 HABERSHAM AT NORTHLAKE
Practice Address - Street 2:BLDG. A
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4009
Practice Address - Country:US
Practice Address - Phone:678-406-9707
Practice Address - Fax:678-406-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty