Provider Demographics
NPI:1336582055
Name:ALICE DEAL LLC
Entity Type:Organization
Organization Name:ALICE DEAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-425-8900
Mailing Address - Street 1:1 HUNTINGTON RD
Mailing Address - Street 2:703
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7204
Mailing Address - Country:US
Mailing Address - Phone:706-425-8900
Mailing Address - Fax:706-425-8600
Practice Address - Street 1:1 HUNTINGTON RD
Practice Address - Street 2:703
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7204
Practice Address - Country:US
Practice Address - Phone:706-425-8900
Practice Address - Fax:706-425-8600
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALICE DEAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0042841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty