Provider Demographics
NPI:1710284369
Name:PROVIDER RESOURCE SOLUTIONS OF GEORGIA INC
Entity Type:Organization
Organization Name:PROVIDER RESOURCE SOLUTIONS OF GEORGIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CROCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-829-2715
Mailing Address - Street 1:101 BECKETT LN
Mailing Address - Street 2:SUITE 505
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7155
Mailing Address - Country:US
Mailing Address - Phone:404-829-2715
Mailing Address - Fax:770-460-7976
Practice Address - Street 1:101 BECKETT LN
Practice Address - Street 2:SUITE 505
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7155
Practice Address - Country:US
Practice Address - Phone:404-829-2715
Practice Address - Fax:770-460-7976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency