Organization
COLLECTIVE COMMUNITIES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAWNDRA JOVAN ECHOLS (MANAGING DIRECTOR)
(770) 648-5293
Entity
Organization
Contact information
Practice address
217 ARROWHEAD BLVD UNIT 81, JONESBORO, GA 30236-1169
(770) 648-5293
Mailing address
110 WALTER WAY UNIT 1562, STOCKBRIDGE, GA 30281-9515
(678) 756-1772
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003227996A
—
GA
05
—
003227996B
—
GA
05
—
003231691A
—
GA
Enumeration date
02/17/2023
Last updated
02/17/2023
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