Provider Demographics
NPI:1538657283
Name:COLLABORATIVE RESOURCE SOLUTIONS LLC
Entity Type:Organization
Organization Name:COLLABORATIVE RESOURCE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKKA
Authorized Official - Middle Name:
Authorized Official - Last Name:VATTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-394-1899
Mailing Address - Street 1:170 BOULEVARD SE APT H419
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-2381
Mailing Address - Country:US
Mailing Address - Phone:404-394-1899
Mailing Address - Fax:
Practice Address - Street 1:5883 GLENRIDGE DR STE 170
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-394-1899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-27
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001034106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty