Provider Demographics
NPI:1982314399
Name:LEVEL AHEAD GEORGIA LLC
Entity Type:Organization
Organization Name:LEVEL AHEAD GEORGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:JALAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-577-2240
Mailing Address - Street 1:4208 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5720
Mailing Address - Country:US
Mailing Address - Phone:718-557-2240
Mailing Address - Fax:
Practice Address - Street 1:1221 RIDGEWAY RD
Practice Address - Street 2:
Practice Address - City:WAVERLY HALL
Practice Address - State:GA
Practice Address - Zip Code:31831-2012
Practice Address - Country:US
Practice Address - Phone:706-365-0440
Practice Address - Fax:332-777-1719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty