Destined 4 Greatness
Organization Active NPI Community/Behavioral Health Agency · Sugar Hill, GA
NPI 1245583194 · NPPES record last updated Oct 16, 2012
Key facts
- NPI
- 1245583194
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- DESTINED 4 GREATNESS
- Practice address
- 698 Grand Folia CT
Sugar Hill, GA 30518-5593 - Phone
- (404) 597-9490
- NPI assigned
- Oct 16, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. Jimmie L Warren
- Title
- Executive Director
- Phone
- (404) 597-9490
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Yes | ||
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | |||
| Non-emergency Medical Transport (VAN) | 343900000X | |||
| Child Mental Illness Respite Care | 385HR2055X |
Addresses
Primary practice location
698 Grand Folia CT
Sugar Hill, GA 30518-5593
Mailing address
698 Grand Folia CT
Sugar Hill, GA 30518-5593
Phone (404) 597-9490
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GA | Medicaid | GA |
Other providers in Sugar Hill, GA
- Hayley Dahl
- Dansforth, Inc
- James Gordon Davis
- Deal Dynamics Inc
- Amy Denslinger
- Destined Horizons, Inc
- Natasha Diaz-Vidal
- Latoya Drayton
- Barbara An Eason
- Edlyn Healthcare Services, Inc
All providers in Sugar Hill, GA · Community/Behavioral Health Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.