Provider Demographics
NPI:1265083539
Name:ORBEXUS PRACTITIONERS LLC
Entity type:Organization
Organization Name:ORBEXUS PRACTITIONERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSAUNDRA
Authorized Official - Middle Name:ANGELINA
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:NLP PRACTITIONER, LC
Authorized Official - Phone:678-666-2545
Mailing Address - Street 1:3904 WELHAM GREEN CT
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-7236
Mailing Address - Country:US
Mailing Address - Phone:678-666-2545
Mailing Address - Fax:
Practice Address - Street 1:3904 WELHAM GREEN CT
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-7236
Practice Address - Country:US
Practice Address - Phone:678-666-2545
Practice Address - Fax:678-666-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No174200000XOther Service ProvidersMeals
No251K00000XAgenciesPublic Health or Welfare
No252Y00000XAgenciesEarly Intervention Provider Agency
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization