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Organization
YOUTH EVOLUTION TRACK LLC
Active
Organization
YOUTH EVOLUTION TRACK LLC
Active
Other names
Empowerment Consulting Enterprise, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAVIS (CREDENTIALING SPECIALISTS)
(912) 373-4385
Entity
Organization
Contact information
Practice address
224 STEPHENSON AVE STE B, SAVANNAH, GA 31405-5921
(912) 675-3421
Mailing address
125 CLOVER POINT CIR, GUYTON, GA 31312-7134
(912) 675-3421
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124764
DRUG AND ALCOHOL
GA
Enumeration date
01/08/2021
Last updated
01/08/2021
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