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LOGANVILLE COMMUNITY MINISTRY VILLAGE INC. NPI 1124253679


NPI Information

NPI: 1124253679
Provider Name: LOGANVILLE COMMUNITY MINISTRY VILLAGE, INC.
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
678 TOM BREWER RD
LOGANVILLE, GA
ZIP 30052
Phone: (770) 554-3599
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LOGANVILLE COMMUNITY MINISTRY VILLAGE, INC. is a community behavioral health in Loganville, GA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. LOGANVILLE COMMUNITY MINISTRY VILLAGE, INC. NPI is 1124253679. The provider is registered as an organization entity type.

The provider's business location address is:

678 TOM BREWER RD
LOGANVILLE, GA
ZIP 30052-005
Phone: (770) 554-3599
Fax: (770) 554-3514

The provider's authorized official is Chet Allen Fowler .
The authorized official title is Executive Director and has the following contact phone number (770) 554-3599.

The enumeration date for this NPI number is 5/27/2009 and was last updated on 5/27/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthLPC005585GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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