Emanuel Malik Anderson
Individual provider Active NPI Community/Behavioral Health Agency · Fort Valley, GA
NPI 1568094449 · NPPES record last updated Feb 7, 2020
Key facts
- NPI
- 1568094449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Practice address
- 410 E Church St
Fort Valley, GA 31030-3097 - Phone
- (478) 825-6499
- NPI assigned
- Feb 7, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
410 E Church St
Fort Valley, GA 31030-3097
Mailing address
410 E Church St
Fort Valley, GA 31030-3097
Phone (478) 825-6499
Other providers in Fort Valley, GA
- A Blessing Place Home Care Services LLC
- Willie Adams
- Adonai Services
- Ekene Emmanuel Aguh
- Latrina Avant
- Avera Drug Co
- Renee Nichols Bailey
- Allison Marie Ball
- Shantaviuis Senise Banks
All providers in Fort Valley, 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 Feb 7, 2020. 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.