Provider Demographics
NPI:1891570644
Name:CRIM GROUP NETWORK
Entity Type:Organization
Organization Name:CRIM GROUP NETWORK
Other - Org Name:CRIM CARES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRIM
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:404-279-0114
Mailing Address - Street 1:3455 PEACHTREE RD NE FL 5
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-3254
Mailing Address - Country:US
Mailing Address - Phone:404-279-0114
Mailing Address - Fax:866-629-9688
Practice Address - Street 1:3455 PEACHTREE RD NE FL 5
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-3254
Practice Address - Country:US
Practice Address - Phone:404-279-0114
Practice Address - Fax:866-629-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child