Provider Demographics
NPI:1699806240
Name:MURPHY-HARPST CHILDREN'S CENTERS
Entity Type:Organization
Organization Name:MURPHY-HARPST CHILDREN'S CENTERS
Other - Org Name:MURPHY-HARPST VASHTI, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO, PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-748-1500
Mailing Address - Street 1:740 FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:CEDARTOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30125-3249
Mailing Address - Country:US
Mailing Address - Phone:770-748-1500
Mailing Address - Fax:770-749-1094
Practice Address - Street 1:740 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:CEDARTOWN
Practice Address - State:GA
Practice Address - Zip Code:30125-3249
Practice Address - Country:US
Practice Address - Phone:770-748-1500
Practice Address - Fax:770-749-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACCI-10006251S00000X, 322D00000X
GA115-624-D251S00000X
GACCI001408322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA832028689AMedicaid