Provider Demographics
NPI:1922403500
Name:COORDINATION SERVICES OF ATLANTA INC.
Entity Type:Organization
Organization Name:COORDINATION SERVICES OF ATLANTA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER/SERVICE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMBRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:229-815-4636
Mailing Address - Street 1:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:MONTEZUMA
Mailing Address - State:GA
Mailing Address - Zip Code:31063-0531
Mailing Address - Country:US
Mailing Address - Phone:229-815-4638
Mailing Address - Fax:
Practice Address - Street 1:207 MYRTLEWOOD DR
Practice Address - Street 2:
Practice Address - City:MONTEZUMA
Practice Address - State:GA
Practice Address - Zip Code:31063-7233
Practice Address - Country:US
Practice Address - Phone:229-815-4638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-25
Last Update Date:2014-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health