Provider Demographics
NPI:1134769961
Name:MAGNIFYING EXPECTATIONS LLC
Entity type:Organization
Organization Name:MAGNIFYING EXPECTATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERON
Authorized Official - Middle Name:QUNISE
Authorized Official - Last Name:CROUCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-642-8509
Mailing Address - Street 1:3840 SHENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-7119
Mailing Address - Country:US
Mailing Address - Phone:678-642-8509
Mailing Address - Fax:
Practice Address - Street 1:1702 HUDSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6387
Practice Address - Country:US
Practice Address - Phone:678-642-8509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health