Organization
CAPITAL CITY COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. FAMIKA LASHELL ROBERTSON PHD, ICADC, SAP, NAM (CHIEF EXECUTIVE DIRECTOR)
(770) 415-7200
Entity
Organization
Contact information
Practice address
5701 MABLETON PKWY, STE# 102, MABLETON, GA 30126-2045
(770) 415-7200
(470) 689-0006
Mailing address
5701 MABLETON PKWY, STE# 102, MABLETON, GA 30126-2045
(770) 415-7200
(470) 689-0006
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
GA
251B00000X
Case Management Agency
—
GA
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4567
NRC SUBSTANCE ABUSE EXPERT
GA
01
—
DOT SAP# 20618
US DEPARTMENT OF TRANSPORTATION
GA
01
—
GA CSAC-3058-R
GEORGIA ADDICTION COUNSELING ASSOCIATION
GA
Enumeration date
06/25/2015
Last updated
03/23/2016
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