Provider Demographics
NPI:1568115525
Name:SET GOALS YCDI LLC,
Entity Type:Organization
Organization Name:SET GOALS YCDI LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:140-451-4119
Mailing Address - Street 1:1907 SIMMONS LN
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-5347
Mailing Address - Country:US
Mailing Address - Phone:404-514-1197
Mailing Address - Fax:
Practice Address - Street 1:1907 SIMMONS LN
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-5347
Practice Address - Country:US
Practice Address - Phone:404-514-1197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)