Provider Demographics
NPI:1295159010
Name:ONE COMMUNITY BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:ONE COMMUNITY BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADIB
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAKIR
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:202-246-7248
Mailing Address - Street 1:3783 PRESIDENTIAL PKWY
Mailing Address - Street 2:SUITE 125
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-3709
Mailing Address - Country:US
Mailing Address - Phone:202-246-7248
Mailing Address - Fax:
Practice Address - Street 1:3783 PRESIDENTIAL PKWY
Practice Address - Street 2:SUITE 125
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-3709
Practice Address - Country:US
Practice Address - Phone:202-246-7248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)