Provider Demographics
NPI:1548564172
Name:ALL KIDS FIRST EARLY INTERVENTION SERVICES, LLC.
Entity Type:Organization
Organization Name:ALL KIDS FIRST EARLY INTERVENTION SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTIKULAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-394-3382
Mailing Address - Street 1:1856 ATKINSON ROAD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045
Mailing Address - Country:US
Mailing Address - Phone:404-394-3382
Mailing Address - Fax:678-302-3453
Practice Address - Street 1:2959 STANSTEAD CIR
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-5000
Practice Address - Country:US
Practice Address - Phone:404-394-3382
Practice Address - Fax:678-302-3453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0-090-3051251S00000X
GA0-090-3036251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health