Wonder Years Pch

LBN: Wonder Years Pch
Wonder Years Pch is an health care organization with primary practice located at 3321 Old Salem Rd Se , Conyers GA 30013-2224. The organization recently has only one registered license in Agencies / Day Training, Developmentally Disabled Services, which is considered as the primary health care specialty. Wonder Years Pch can be contacted via phone (770) 860-1320, or through Tillman, Angela B via phone (773) 354-3040.

Contact Information

Primary practice address
3321 Old Salem Rd Se Conyers GA 30013-2224
Phone: (770) 860-1320
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Tillman, Angela B
Phone: (773) 354-3040

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X

Profile Details

NPI number 1225354624
LBN Legal business name Wonder Years Pch
DBA Doing business as
Authorized official Tillman, Angela B
Entity Organization
Organization subpart 1 No
Enumeration date Apr 12th, 2010
Last updated Apr 12th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1225354624 NPPES
Georgia MEDICAID 124269217A

Popular Providers