Provider Demographics
NPI:1770920340
Name:MANDALAY CONSULTING LLC
Entity type:Organization
Organization Name:MANDALAY CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTIHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-927-7332
Mailing Address - Street 1:574 COLD WATER LN
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-8068
Mailing Address - Country:US
Mailing Address - Phone:678-927-7332
Mailing Address - Fax:
Practice Address - Street 1:574 COLD WATER LN
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-8068
Practice Address - Country:US
Practice Address - Phone:678-927-7332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANDALAY CONSULTING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management