Provider Demographics
NPI:1477971463
Name:THE UPPER ROOM POWER CENTER INC
Entity Type:Organization
Organization Name:THE UPPER ROOM POWER CENTER INC
Other - Org Name:THE UPPER ROOM POWER CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING/DIRECTING EMPLOYEES
Authorized Official - Prefix:
Authorized Official - First Name:ARLEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-447-6207
Mailing Address - Street 1:1115 MORROW RD
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-1066
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1115 MORROW RD
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-1066
Practice Address - Country:US
Practice Address - Phone:404-447-6207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness