Provider Demographics
NPI:1467614222
Name:ATLANTA SECURE CARE SERVICE, INC
Entity Type:Organization
Organization Name:ATLANTA SECURE CARE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFIE
Authorized Official - Middle Name:V
Authorized Official - Last Name:IGBADUME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-622-8099
Mailing Address - Street 1:2399 MONTE VILLA CTS
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-2897
Mailing Address - Country:US
Mailing Address - Phone:678-622-8099
Mailing Address - Fax:770-222-0084
Practice Address - Street 1:2399 MONTE VILLA CTS
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-2897
Practice Address - Country:US
Practice Address - Phone:678-622-8099
Practice Address - Fax:770-222-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility