Side By Side Clubhouse, Inc.

LBN: Side By Side Clubhouse, Inc.
Side By Side Clubhouse, Inc. is an health care organization with primary practice located at 1001 Main St , Stone Mountain GA 30083-2922. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Side By Side Clubhouse, Inc. can be contacted via phone (404) 378-1139, or through Johnson, Cynthia via phone (770) 469-9355.

Contact Information

Primary practice address
1001 Main St Stone Mountain GA 30083-2922
Phone: (404) 378-1139
Fax: (404) 378-1164
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Cynthia Master of Arts (MA)
Phone: (770) 469-9355

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1275674186
LBN Legal business name Side By Side Clubhouse, Inc.
DBA Doing business as
Authorized official Johnson, Cynthia Master of Arts (MA)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 12th, 2007
Last updated May 5th, 2010 - about 14 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 1275674186 NPPES
Georgia MEDICAID 000877676A

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