1588002380 NPI number — BEFORE&AFTER SUPPORTIVE HOUSING SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588002380 NPI number — BEFORE&AFTER SUPPORTIVE HOUSING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEFORE&AFTER SUPPORTIVE HOUSING SERVICES
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:
1588002380
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6388 LAUREL POST CT
Provider Second Line Business Mailing Address:
1115 LESLIE PLACE
Provider Business Mailing Address City Name:
LITHONIA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30058-8982
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-207-5308
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1434 SCOTT BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30030-1424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-399-1843
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2013

Additional Information

Authorized Official

Authorized Official Last Name:
SEMPLE
Authorized Official First Name:
ORITA
Authorized Official Middle Name:
WENDELLA
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
404-399-1843

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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