Provider Demographics
NPI:1639572803
Name:DIRECT APPROACH COMMUNITY SUPPORT
Entity Type:Organization
Organization Name:DIRECT APPROACH COMMUNITY SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KAREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-358-2842
Mailing Address - Street 1:1195 MILTON TER SE APT 1303
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-2426
Mailing Address - Country:US
Mailing Address - Phone:404-358-2842
Mailing Address - Fax:
Practice Address - Street 1:1195 MILTON TER SE APT 1303
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-2426
Practice Address - Country:US
Practice Address - Phone:404-358-2842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health