Organization
AFRICAN AMERICAN TASK FORCE FOR SUBSTANCE ABUSE PREVENTION
Active
Other names
Byrd House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EDITH RENEE BYRD (EXECUTIVE DIRECTOR)
(678) 423-3200
Entity
Organization
Contact information
Practice address
19 PERRY ST, NEWNAN, GA 30263-1918
(678) 423-3200
Mailing address
PO BOX 72001, NEWNAN, GA 30271-2001
(678) 423-3200
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
06/24/2008
Last updated
11/19/2010
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