Organization
SUPAID COMMUNITY RESOURCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA A. ROBERTS DDP (DIRECTOR/DDP)
(678) 763-6722
Entity
Organization
Contact information
Practice address
750 JAMESTOWN XING, JONESBORO, GA 30238-4384
(678) 610-7255
(678) 610-7255
Mailing address
750 JAMESTOWN XING, JONESBORO, GA 30238-4384
(678) 610-7255
(678) 610-7255
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Enumeration date
10/22/2014
Last updated
10/25/2014
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