| Positive Transition Service Inc | |
|
3480 Greenbriar Pkwy Sw Ste 216 Atlanta GA 30331-3126 | |
| (678) 298-6140 | |
| Not Available |
| Full Name | Positive Transition Service Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3480 Greenbriar Pkwy Sw Ste 216, Atlanta, Georgia |
| Authorized Official Name and Position | Bartola Anderson (CEO) |
| Authorized Official Contact | 7703749664 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Transition Service Inc 3645 Marketplace Blvd Ste 130-546 Atlanta GA 30344-5747 Ph: () - | Positive Transition Service Inc 3480 Greenbriar Pkwy Sw Ste 216 Atlanta GA 30331-3126 Ph: (678) 298-6140 |
| NPI Number | 1235847542 |
|---|---|
| Provider Enumeration Date | 11/07/2022 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Medicare PECOS PAC ID | 3971976499 |
|---|---|
| Medicare Enrollment ID | O20230303001660 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235847542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kamirah Nishae Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679173686 PECOS PAC ID: 6305254806 Enrollment ID: I20210422000782 |
| Provider Name | Lloydstone Leonard Jacobs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881816700 PECOS PAC ID: 0143685909 Enrollment ID: I20230501000025 |
| Provider Name | Chastity Quave |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518577253 PECOS PAC ID: 2769846682 Enrollment ID: I20230912000244 |
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