| Level Up Community Service Program Llc | |
|
6754 Grey Rock Way Lithonia GA 30058-3077 | |
| (678) 849-0505 | |
| Not Available |
| Full Name | Level Up Community Service Program Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6754 Grey Rock Way, Lithonia, Georgia |
| Authorized Official Name and Position | Deborah E Sills (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6788490505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Level Up Community Service Program Llc Po Box 784 Lithonia GA 30058-0784 Ph: (678) 849-0505 | Level Up Community Service Program Llc 6754 Grey Rock Way Lithonia GA 30058-3077 Ph: (678) 849-0505 |
| NPI Number | 1871226977 |
|---|---|
| Provider Enumeration Date | 07/06/2022 |
| Last Update Date | 07/06/2022 |
| Certification Date | 07/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871226977 | NPI | - | NPPES |
| 2014 | Other | GA | 2014 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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