1881735231 NPI number — RICHMONT GRADUATE UNIVERSITY

Table of content: (NPI 1881735231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881735231 NPI number — RICHMONT GRADUATE UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHMONT GRADUATE UNIVERSITY
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:
PSYCHOLOGICAL STUDIES INSTITUTE
Provider Other Organization Name Type Code:
4
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:
1881735231
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2055 MOUNT PARAN RD NW
Provider Second Line Business Mailing Address:
MCCARTY BUILDING
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30327-2921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-233-3949
Provider Business Mailing Address Fax Number:
404-239-9460

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4200 NORTHSIDE PKWY NW
Provider Second Line Business Practice Location Address:
BUILDING FOUR, SUITE 100
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30327-3054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-266-0695
Provider Business Practice Location Address Fax Number:
404-239-9460
Provider Enumeration Date:
02/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HANSHEW
Authorized Official First Name:
EVALIN
Authorized Official Middle Name:
RHODES
Authorized Official Title or Position:
DEAN OF CLINICAL AFFAIRS
Authorized Official Telephone Number:
404-233-3949

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com