Organization
RAVENS NEST FOUNDATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELBY GREEN (CEO)
(770) 819-6825
Entity
Organization
Contact information
Practice address
1680 MULKEY RD STE 200, AUSTELL, GA 30106-1364
(770) 819-6825
(770) 819-6826
Mailing address
1680 MULKEY RD STE 200, AUSTELL, GA 30106-1364
(770) 819-6825
(770) 819-6826
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
—
171W00000X
Contractor
—
—
174400000X
Specialist
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003261381A
—
GA
Enumeration date
12/28/2010
Last updated
01/28/2026
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