Organization
JUNIORS SOCIETY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD JACKSON JR. (CEO/PROGRAM DIRECTOR)
(478) 461-0023
Entity
Organization
Contact information
Practice address
811 CRESTE DR, DECATUR, GA 30035-4135
(478) 461-0023
Mailing address
811 CRESTE DR, DECATUR, GA 30035-4135
(478) 461-0023
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
10/16/2025
Last updated
10/16/2025
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