Provider Demographics
NPI:1245695097
Name:CENTER BEYOND SOLUTIONS, LLC
Entity type:Organization
Organization Name:CENTER BEYOND SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEMETRICE
Authorized Official - Middle Name:WAY
Authorized Official - Last Name:HERNDON
Authorized Official - Suffix:
Authorized Official - Credentials:CADCII
Authorized Official - Phone:470-888-1832
Mailing Address - Street 1:300 W I PKWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-5079
Mailing Address - Country:US
Mailing Address - Phone:470-888-1832
Mailing Address - Fax:
Practice Address - Street 1:300 W I PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-5079
Practice Address - Country:US
Practice Address - Phone:470-888-1832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health