Provider Demographics
NPI:1578885505
Name:SBZ SERVICES UNLIMITED, INC
Entity Type:Organization
Organization Name:SBZ SERVICES UNLIMITED, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:BRYANT
Authorized Official - Last Name:ZELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-898-2306
Mailing Address - Street 1:122 CHAMLEE WAY
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-6667
Mailing Address - Country:US
Mailing Address - Phone:678-898-2306
Mailing Address - Fax:678-432-3330
Practice Address - Street 1:122 CHAMLEE WAY
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-6667
Practice Address - Country:US
Practice Address - Phone:678-898-2306
Practice Address - Fax:678-432-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004347101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA500341942BMedicaid
GA500341942DMedicaid
GA500341942CMedicaid