Think Big Youth Organization LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

THINK BIG YOUTH ORGANIZATION LLC

Practice address

9784 E Oglethorpe Hwy Ste C
Midway, GA 31320-4546

Phone

(912) 610-3466

NPI assigned

Oct 5, 2020

Last updated

Oct 5, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Demmentrice Jefferson

Title

Director

Phone

(912) 610-3466

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1235736182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9784 E OGLETHORPE HWY STE C",
            "city": "MIDWAY",
            "state": "GA",
            "postal_code": "313204546",
            "telephone_number": "912-610-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9784 E OGLETHORPE HWY STE C",
            "city": "MIDWAY",
            "state": "GA",
            "postal_code": "313204546",
            "telephone_number": "912-610-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THINK BIG YOUTH ORGANIZATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "DEMMENTRICE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "912-610-3466",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELING SERVICES",
            "identifier": "2020",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thinkbigyth2015@gmail.com",
            "affiliation": "N",
            "address_1": "9784 E Oglethorpe Hwy Ste C",
            "city": "Midway",
            "state": "GA",
            "country_code": "US",
            "postal_code": "313204546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Case Management Agency in Midway, GA
• Providers in Midway, GA by specialty
• Case Management Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.