Provider Demographics
NPI:1821704495
Name:BR8K THRU SUPPORT SERVICES
Entity Type:Organization
Organization Name:BR8K THRU SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:202-292-8491
Mailing Address - Street 1:5701 MABLETON PKWY SW STE 201
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-3364
Mailing Address - Country:US
Mailing Address - Phone:470-869-2175
Mailing Address - Fax:
Practice Address - Street 1:5701 MABLETON PKWY SW STE 201
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-3364
Practice Address - Country:US
Practice Address - Phone:470-869-2175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health