1700328309 NPI number — HEALTH EDUCATION ASSESSMENT AND LEADERSHIP, INC

Table of content: (NPI 1700328309)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700328309 NPI number — HEALTH EDUCATION ASSESSMENT AND LEADERSHIP, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH EDUCATION ASSESSMENT AND LEADERSHIP, 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:
1700328309
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3915 CASCADE RD SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30331-8512
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-564-7749
Provider Business Mailing Address Fax Number:
404-758-1216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4215 BAKERS FERRY RD SW
Provider Second Line Business Practice Location Address:
MILES ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30331-4401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-791-1165
Provider Business Practice Location Address Fax Number:
404-758-1216
Provider Enumeration Date:
11/14/2016

Additional Information

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
SHAWN
Authorized Official Middle Name:
Authorized Official Title or Position:
REVENUE CYCLE MANAGER
Authorized Official Telephone Number:
404-564-7749

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , 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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