Provider Demographics
NPI:1639749054
Name:TO OUR SHORES, INC
Entity Type:Organization
Organization Name:TO OUR SHORES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/FNP
Authorized Official - Prefix:DR
Authorized Official - First Name:MIYESHA
Authorized Official - Middle Name:ASATU
Authorized Official - Last Name:CHEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MSN, FNP-BC
Authorized Official - Phone:917-853-5056
Mailing Address - Street 1:250 LANGLEY DR STE 1101
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-6932
Mailing Address - Country:US
Mailing Address - Phone:917-853-5056
Mailing Address - Fax:
Practice Address - Street 1:250 LANGLEY DR STE 1101
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-6932
Practice Address - Country:US
Practice Address - Phone:770-954-5997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty