Organization
M.C. LIBRARY EDUCATION CENTER CORP
Active
Organization
M.C. LIBRARY EDUCATION CENTER CORP
Active
Other names
MCLECC
Organization subpart
No
Provider details
NPI number
Authorized official
CLEBERT MERAT JR. (CHIEF EXECUTIVE OFFICER)
(678) 508-1068
Entity
Organization
Contact information
Practice address
2520 PARK CENTRAL BLVD STE C2, 322 P O BOX DOUGLASVILLE GA 301333, DECATUR, GA 30035-3924
(678) 508-1068
(678) 248-1716
Mailing address
2520 PARK CENTRAL BLVD STE C2, P . O . BOX 322 DOUGLASVILLE GA 301333, DECATUR, GA 30035-3924
(678) 508-1068
(678) 248-1716
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251T00000X
PACE Provider Organization
—
FL
251V00000X
Voluntary or Charitable Agency
—
FL
251V00000X
Voluntary or Charitable Agency
—
GA
305R00000X
Preferred Provider Organization
—
GA
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
GA
320700000X
Physical Disabilities Residential Treatment Facility
—
FL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
GA
347E00000X
Transportation Broker
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
0
—
Enumeration date
01/27/2011
Last updated
06/20/2018
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