1063813756 NPI number — ROCK SPRINGS POSITIVE COACHING, CARING, AND COUNSELING, INC.

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 1063813756 NPI number — ROCK SPRINGS POSITIVE COACHING, CARING, AND COUNSELING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCK SPRINGS POSITIVE COACHING, CARING, AND COUNSELING, INC.
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:
6
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:
1063813756
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1708 PEACHTREE ST NW # BW
Provider Second Line Business Mailing Address:
SUITE 425
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30309-2434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-721-7409
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1708 PEACHTREE ST NW
Provider Second Line Business Practice Location Address:
SUITE 425
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30309-2434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-721-7409
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
404-721-7409

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CSW003740 , 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)