NPIMap

Organization Active NPI

Interconnected Family and Children Services LLC

  • Case Management Agency
  • Conyers, GA
National Provider Identifier
1609210582
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
CSW004040 Issued in GA
Legal business name
INTERCONNECTED FAMILY AND CHILDREN SERVICES LLC
Practice address
1257 Commercial Dr SW # Sr
Conyers, GA 30094-5991
Phone
(678) 365-2375
Fax
(678) 298-5098
NPI assigned
Apr 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Authorized official

Name
Chris Young
Title
Managing Partner
Phone
(678) 365-2375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X CSW004040 GA Primary

Addresses

Primary practice location

1257 Commercial Dr SW # Sr
Conyers, GA 30094-5991

Mailing address

1257 Commercial Dr SW # Sr
Conyers, GA 30094-5991
Phone (678) 365-2375

National Provider Directory

National Provider Directory
Tax ID family
Dream Builders Counseling2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1609210582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 COMMERCIAL DR SW # SR",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945991",
            "telephone_number": "678-365-2375",
            "fax_number": "678-298-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 COMMERCIAL DR SW # SR",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945991",
            "telephone_number": "678-365-2375",
            "fax_number": "678-298-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCONNECTED FAMILY AND CHILDREN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "678-365-2375"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": "CSW004040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.