Provider Demographics
NPI:1477953354
Name:THE ERVIN ACADEMY, INC
Entity Type:Organization
Organization Name:THE ERVIN ACADEMY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-394-0639
Mailing Address - Street 1:PO BOX 2728
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-0984
Mailing Address - Country:US
Mailing Address - Phone:678-394-0639
Mailing Address - Fax:678-394-0638
Practice Address - Street 1:1872 MILLWOOD PARK CT
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-4400
Practice Address - Country:US
Practice Address - Phone:678-394-0639
Practice Address - Fax:678-394-0638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
No347C00000XTransportation ServicesPrivate Vehicle