Provider Demographics
NPI:1437647708
Name:N'SPIRED BY ACHIEVEMENT FAMILY SERVICES & SOLUTIONS, LLC
Entity Type:Organization
Organization Name:N'SPIRED BY ACHIEVEMENT FAMILY SERVICES & SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GRANVILLE
Authorized Official - Middle Name:THEODORE
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:LPC, NCC, CPCS, DCC
Authorized Official - Phone:404-538-1791
Mailing Address - Street 1:5000 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-6030
Mailing Address - Country:US
Mailing Address - Phone:404-538-1791
Mailing Address - Fax:404-393-7401
Practice Address - Street 1:995 ROSWELL ST NE STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2186
Practice Address - Country:US
Practice Address - Phone:404-913-0557
Practice Address - Fax:404-393-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003155881AMedicaid