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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