Provider Demographics
NPI:1669050258
Name:THE COLLECTIVE ENTERPRISE INC.
Entity type:Organization
Organization Name:THE COLLECTIVE ENTERPRISE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-389-0500
Mailing Address - Street 1:289 LEGENDS TRCE
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8820
Mailing Address - Country:US
Mailing Address - Phone:678-389-0500
Mailing Address - Fax:
Practice Address - Street 1:289 LEGENDS TRCE
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8820
Practice Address - Country:US
Practice Address - Phone:678-389-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No305S00000XManaged Care OrganizationsPoint of Service
No332U00000XSuppliersHome Delivered Meals
No347C00000XTransportation ServicesPrivate Vehicle