# BURNING BUSH YOUTH & FAMILY INTERVENTION CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992047278
- **Authorized official:** DONALD TINSLEY (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (678) 774-8230

## Contact information

- **Practice address:** 144 BROOKWOOD AVE, JACKSON, GA 30233-1403
- **Practice address phone:** (678) 774-8230
- **Practice address fax:** (678) 774-8233
- **Mailing address:** 144 BROOKWOOD AVE, JACKSON, GA 30233-1403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | — |
| 251V00000X | Voluntary or Charitable Agency | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/25/2013
- **Last updated:** 03/25/2013