Provider Demographics
NPI:1568215341
Name:TATE ACADEMY, INC
Entity Type:Organization
Organization Name:TATE ACADEMY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-938-7929
Mailing Address - Street 1:1847 RIVERSIDE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-4767
Mailing Address - Country:US
Mailing Address - Phone:678-938-7929
Mailing Address - Fax:
Practice Address - Street 1:3196 HIGHWAY 515 E STE H
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-3067
Practice Address - Country:US
Practice Address - Phone:678-938-7929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health