Outward Bound Services, Llc

NPI 1114346806 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1114346806
Enumeration Date 04/10/2014
Last Updated 06/17/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name DERRICK DERRICK
Position CEO/OWNER
Phone (336) 382-9618
Fax
Practice Location
2141 SMYRNA RD SW
CONYERS GA, 30094-6168, US
Phone (336) 382-9618
Fax
Business Location
2141 SMYRNA RD SW
CONYERS GA, 30094, US
Phone
Fax
Toxanomy
Taxonomy Code 251S00000X
License State
License Number
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According to our database, Outward Bound Services, Llc NPI is 1114346806, taxonomy code is 251S00000X Outward Bound Services, Llc physically located at 2141 Smyrna Rd Sw, Conyers GA, 30094-6168. NPI Number 1033115704 has the healthcare provider type.

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1114346806 NPI number is provided on an as is basis without warranty of any kind. 1114346806 is maintained by the National Plan & Provider Enumeration System. The contents of Outward Bound Services, Llc are for informational purposes only.