Provider Demographics
NPI:1760815773
Name:NEIGHBORHOOD IMPROVEMENT PROJECT, INC
Entity Type:Organization
Organization Name:NEIGHBORHOOD IMPROVEMENT PROJECT, INC
Other - Org Name:MEDICAL ASSOCIATES PLUS AT WRENS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:706-790-4440
Mailing Address - Street 1:2467 GOLDEN CAMP ROAD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906
Mailing Address - Country:US
Mailing Address - Phone:706-790-4440
Mailing Address - Fax:706-790-4393
Practice Address - Street 1:501 EAST BROAD STREET
Practice Address - Street 2:
Practice Address - City:WRENS
Practice Address - State:GA
Practice Address - Zip Code:30833
Practice Address - Country:US
Practice Address - Phone:706-547-8559
Practice Address - Fax:706-547-0729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14489GA261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)