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Organization

PRESTIGE LEARNING ACADEMY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MONNIQUE MILLINER ED SPECIALIST/MASTER (OWNER/PROVIDER)
(248) 943-5234
Entity
Organization

Contact information

Practice address
6920 BROAD ST, DOUGLASVILLE, GA 30134-1604
(248) 943-5234
Mailing address
6920 BROAD ST, DOUGLASVILLE, GA 30134-1604
(248) 943-5234

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
GA
251C00000X
Developmentally Disabled Services Day Training Agency
GA
252Y00000X
Early Intervention Provider Agency
Primary
739025
GA

Other

Enumeration date
08/08/2013
Last updated
08/08/2013
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