Organization
SOCIAL SERVICES INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY EARL ROBERSON LCSW (CLINICAL DIRECTOR/OWNER)
(770) 944-7280
Entity
Organization
Contact information
Practice address
4581 DURON PL SW, MABLETON, GA 30126-1177
(770) 944-7280
(770) 944-7280
Mailing address
PO BOX 1821, MABLETON, GA 30126-1013
(770) 944-7280
(770) 944-7280
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
CSW001776
GA
251B00000X
Case Management Agency
CSW001776
GA
252Y00000X
Early Intervention Provider Agency
Primary
CSW001776
GA
253Z00000X
In Home Supportive Care Agency
CSW001776
GA
Other
Enumeration date
07/14/2012
Last updated
07/14/2012
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