POSITIVE IMPACT RESIDENTIAL SERVICES NPI 1487079562

NPI Information

  • NPI: 1487079562
  • Provider Name: POSITIVE IMPACT RESIDENTIAL SERVICES
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 2189 W PONCE DE LEON AVE
    DECATUR, GA
    ZIP 30030
  • Phone: (678) 887-3263

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NPI Details

POSITIVE IMPACT RESIDENTIAL SERVICES is a mental health (including community mental health center) clinic center in Decatur, GA. POSITIVE IMPACT RESIDENTIAL SERVICES NPI is 1487079562. The provider is registered as an organization entity type.

The provider's business location address is:

2189 W PONCE DE LEON AVE
DECATUR, GA
ZIP 30030-334
Phone: (678) 887-3263
Fax: (404) 687-9871

The provider's authorized official is Wax Flowers .
The authorized official title is Lcsw/owner and has the following contact phone number (866) 730-7604.

The enumeration date for this NPI number is 2/25/2014 and was last updated on 2/25/2014.

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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)CSW002378GEORGIAYes

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: 3/30/2025

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