Provider Demographics
NPI:1336623834
Name:PROACT LLC
Entity Type:Organization
Organization Name:PROACT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRET
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-211-5184
Mailing Address - Street 1:6160 PEACHTREE DUNWOODY RD STE A103
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4578
Mailing Address - Country:US
Mailing Address - Phone:800-211-5184
Mailing Address - Fax:855-273-0654
Practice Address - Street 1:6160 PEACHTREE DUNWOODY RD STE A103
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4578
Practice Address - Country:US
Practice Address - Phone:800-211-5184
Practice Address - Fax:855-273-0654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic