Provider Demographics
NPI:1609669738
Name:SUPER SUPPORTIVE TEACHING FOR ACHIEVING REMARKABLE SUCCESS INC
Entity type:Organization
Organization Name:SUPER SUPPORTIVE TEACHING FOR ACHIEVING REMARKABLE SUCCESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SRAVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-249-9206
Mailing Address - Street 1:4515 WILDBROOKE PKWY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-4824
Mailing Address - Country:US
Mailing Address - Phone:678-249-9206
Mailing Address - Fax:
Practice Address - Street 1:5230 JOT EM DOWN RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-3406
Practice Address - Country:US
Practice Address - Phone:678-249-9206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center