Provider Demographics
NPI:1740722420
Name:HEALTH EDUCATION ASSESSMENT AND LEADERSHIP, INC
Entity type:Organization
Organization Name:HEALTH EDUCATION ASSESSMENT AND LEADERSHIP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-704-4336
Mailing Address - Street 1:3915 CASCADE RD SW STE T-90
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8660
Mailing Address - Country:US
Mailing Address - Phone:404-564-7749
Mailing Address - Fax:404-758-1216
Practice Address - Street 1:3666 HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-6939
Practice Address - Country:US
Practice Address - Phone:404-564-7749
Practice Address - Fax:404-699-6798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003178709AMedicaid