Provider Demographics
NPI:1629635875
Name:DFCS-REGION 1 FIELD FISCAL OFFICE
Entity Type:Organization
Organization Name:DFCS-REGION 1 FIELD FISCAL OFFICE
Other - Org Name:REGION 1 REGIONAL ACCOUNTING
Other - Org Type:Other Name
Authorized Official - Title/Position:FISCAL OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLECHOVA
Authorized Official - Suffix:
Authorized Official - Credentials:ING
Authorized Official - Phone:706-624-1245
Mailing Address - Street 1:PO BOX 999
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30703
Mailing Address - Country:US
Mailing Address - Phone:706-624-1245
Mailing Address - Fax:706-624-1196
Practice Address - Street 1:621 MAULDIN RD NW
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-8508
Practice Address - Country:US
Practice Address - Phone:706-624-1245
Practice Address - Fax:706-624-1196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)