Provider Demographics
NPI:1811228968
Name:MCKINLEY ALLIANCE GROUP
Entity type:Organization
Organization Name:MCKINLEY ALLIANCE GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AYSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-685-6971
Mailing Address - Street 1:1567 JANMAR RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5769
Mailing Address - Country:US
Mailing Address - Phone:770-685-6971
Mailing Address - Fax:770-685-6973
Practice Address - Street 1:1567 JANMAR RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5769
Practice Address - Country:US
Practice Address - Phone:770-685-6971
Practice Address - Fax:770-685-6973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2010OCC-004515385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care