Provider Demographics
NPI:1841514551
Name:MOMMY N ME OF GEORGIA INC.
Entity type:Organization
Organization Name:MOMMY N ME OF GEORGIA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-784-5526
Mailing Address - Street 1:1376 TRAVERS CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3585
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1376 TRAVERS CREEK TRL
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3585
Practice Address - Country:US
Practice Address - Phone:404-784-5536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No253J00000XAgenciesFoster Care Agency