1427100783 NPI number — CHRISTIAN CENTERED EMPOWERMENT, INC.

Table of content: (NPI 1427100783)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427100783 NPI number — CHRISTIAN CENTERED EMPOWERMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTIAN CENTERED EMPOWERMENT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CCEP, INC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427100783
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 370080
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DECATUR
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30037-0080
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-472-7318
Provider Business Mailing Address Fax Number:
404-795-8974

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2745 MOUNT ZION RD
Provider Second Line Business Practice Location Address:
102
Provider Business Practice Location Address City Name:
JONESBORO
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30236-6890
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-472-7318
Provider Business Practice Location Address Fax Number:
404-795-8974
Provider Enumeration Date:
01/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GUYTON
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
N
Authorized Official Title or Position:
FOUNDERCEO
Authorized Official Telephone Number:
404-795-8974

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)