Provider Demographics
NPI:1417561119
Name:UNITED METRO BOYS ACADEMY LLC
Entity Type:Organization
Organization Name:UNITED METRO BOYS ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-713-7050
Mailing Address - Street 1:720 DUNLEITH CT SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-3718
Mailing Address - Country:US
Mailing Address - Phone:404-713-7050
Mailing Address - Fax:
Practice Address - Street 1:720 DUNLEITH CT SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-3718
Practice Address - Country:US
Practice Address - Phone:404-713-7050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty