Organization
CREEKSIDE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL REYNOLDS (PRESIDENT/CEO)
(404) 786-4440
Entity
Organization
Contact information
Practice address
5800 MOUNTAIN CREEK RD NE, SANDY SPRINGS, GA 30328-5035
(404) 228-6554
(404) 963-0555
Mailing address
5800 MOUNTAIN CREEK RD NE, SANDY SPRINGS, GA 30328-5035
(404) 228-6554
(404) 963-0555
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW004998
GA
133N00000X
Nutritionist
—
—
164W00000X
Licensed Practical Nurse
—
GA
171100000X
Acupuncturist
39
GA
171M00000X
Case Manager/Care Coordinator
—
GA
171W00000X
Contractor
—
—
175F00000X
Naturopath
—
GA
376K00000X
Nurse's Aide
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006602
PCH
GA
01
—
520306
JOINT COMMISSION HEALTHCARE ORGANIZATION
GA
Enumeration date
12/21/2011
Last updated
12/21/2011
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