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Organization

LEVEL UP COMMUNITY SERVICE PROGRAM LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEBORAH E SILLS PHD LCSW (EXECUTIVE DIRECTOR)
(678) 849-0505
Entity
Organization

Contact information

Practice address
6754 GREY ROCK WAY, LITHONIA, GA 30058-3077
(678) 849-0505
Mailing address
PO BOX 784, LITHONIA, GA 30058-0784
(678) 849-0505

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2014
2014
GA
Enumeration date
07/06/2022
Last updated
07/06/2022
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