1205138864 NPI number — SPECIAL TRANSITION WORKS , LLC

Table of content: CALE ARMSTRONG (NPI 1578129995)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205138864 NPI number — SPECIAL TRANSITION WORKS , LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPECIAL TRANSITION WORKS , LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205138864
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2100 RIVERSIDE PKWY STE 128-144
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCEVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30043-5927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-541-6212
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11340 LAKEFIELD DR STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNS CREEK
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30097-2456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-331-8604
Provider Business Practice Location Address Fax Number:
800-331-8604
Provider Enumeration Date:
12/02/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MEADOWS
Authorized Official First Name:
NYMPHA
Authorized Official Middle Name:
JAMIE
Authorized Official Title or Position:
PRINCIPLE OWNER
Authorized Official Telephone Number:
800-331-8604

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)