Provider Demographics
NPI:1720748429
Name:UNITED METHODIST CHILDREN'S HOME OF THE NORTH GEORGIA CONFERENCE, INC.
Entity Type:Organization
Organization Name:UNITED METHODIST CHILDREN'S HOME OF THE NORTH GEORGIA CONFERENCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PERFORMANCE & QUALITY
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-327-5820
Mailing Address - Street 1:1967 LAKESIDE PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-5867
Mailing Address - Country:US
Mailing Address - Phone:404-327-5820
Mailing Address - Fax:
Practice Address - Street 1:1967 LAKESIDE PKWY STE 400
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5867
Practice Address - Country:US
Practice Address - Phone:404-327-5820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty