Provider Demographics
NPI:1740528652
Name:MULTI-SERVICES AND COMMUNITY SUPPORTS, LLC
Entity type:Organization
Organization Name:MULTI-SERVICES AND COMMUNITY SUPPORTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-833-2851
Mailing Address - Street 1:116 LAUGHLIN DR
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-6015
Mailing Address - Country:US
Mailing Address - Phone:770-833-2851
Mailing Address - Fax:
Practice Address - Street 1:116 LAUGHLIN DR
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-6015
Practice Address - Country:US
Practice Address - Phone:770-833-2851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency