Organization
5678DANCENOW.INC
Active
Other names
5678dancenow.inc
Organization subpart
No
Provider details
NPI number
Authorized official
AYESHA TREACHEA WATSON MS (CEO)
(770) 369-6999
Entity
Organization
Contact information
Practice address
4035 JONESBORO RD, FOREST PARK, GA 30297-1089
(770) 369-6999
Mailing address
4645 JACKYBELL TRL, DECATUR, GA 30034-6350
(770) 369-6999
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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