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Organization
BY YOUR SIDE GEORGIA, LLC
Active
Organization
BY YOUR SIDE GEORGIA, LLC
Active
Parent organization
BY YOUR SIDE LLC
Other names
BY YOUR SIDE
Organization subpart
Yes
Provider details
NPI number
Legal business name
BY YOUR SIDE LLC
Authorized official
MATTHEW SULLIVAN (CFO)
(770) 884-1050
Entity
Organization
Contact information
Practice address
3070 BUSINESS PARK DR STE B, NORCROSS, GA 30071-1428
(770) 884-1050
(770) 884-1051
Mailing address
3070 BUSINESS PARK DR STE B, NORCROSS, GA 30071-1428
(770) 884-1050
(770) 884-1051
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
07/24/2019
Last updated
11/23/2020
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