Dekalb Community Service Board

Organization Active NPI Community/Behavioral Health Agency · Chamblee, GA

NPI 1154466142 · NPPES record last updated Apr 23, 2020

Key facts

NPI
1154466142
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
DEKALB COMMUNITY SERVICE BOARD
Practice address
3571 Embry Cir
Chamblee, GA 30341-5613
Phone
(770) 986-8746
Fax
(770) 986-8746
NPI assigned
Feb 20, 2007
Organization subpart
Yes
Parent organization (as reported)
DEKALB COMMUNITY SERVICE BOARD

Authorized official

Name
Fabio Bruno Van Der Merwe
Title
Coo
Phone
(404) 294-3836

Corporate family (same tax ID) 23

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Dekalb Community Serv (24 organizations share this tax ID)
Part of
Dekalb Community Serv

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

3571 Embry Cir
Chamblee, GA 30341-5613

Mailing address

445 Winn Way FL 4
Decatur, GA 30030-1707
Phone (404) 294-3836

Other names

  • Embry Circle Group Home Other name

Other providers in Chamblee, GA

All providers in Chamblee, GA · Community/Behavioral Health Agency in Georgia

Sources for this page

Verify at the official NPI Registry.