Ravens Nest Foundation Inc

LBN: Ravens Nest Foundation Inc
Ravens Nest Foundation Inc is an health care organization with primary practice located at 3875 Austell Rd Ste 303 , Austell GA 30106-1153. The organization recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Social Worker, Other Service Providers / Contractor, Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is the primary health care specialty. Ravens Nest Foundation Inc can be contacted via phone (770) 819-6825, or through Green, Shelby via phone (770) 819-6825.

Contact Information

Primary practice address
3875 Austell Rd Ste 303 Austell GA 30106-1153
Phone: (770) 819-6825
Fax: (770) 819-6826
Website:
Map and Directions
Authorized official contact:
Name: Green, Shelby
Phone: (770) 819-6825

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Social Worker 104100000X
Other Service Providers / Contractor 171W00000X
Other Service Providers / Specialist 174400000X
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X

Profile Details

NPI number 1578867982
LBN Legal business name Ravens Nest Foundation Inc
DBA Doing business as
Authorized official Green, Shelby
Entity Organization
Organization subpart 1 No
Enumeration date Dec 28th, 2010
Last updated Mar 27th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578867982 NPPES
Georgia MEDICAID 003111706A

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