Provider Demographics
NPI:1902265333
Name:SBZ SERVICES UNLIMITED, INC
Entity Type:Organization
Organization Name:SBZ SERVICES UNLIMITED, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CADC II, CPCS
Authorized Official - Phone:678-432-3330
Mailing Address - Street 1:125 S ZACK HINTON PKWY
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3335
Mailing Address - Country:US
Mailing Address - Phone:678-432-3330
Mailing Address - Fax:678-432-3662
Practice Address - Street 1:125 S ZACK HINTON PKWY
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3335
Practice Address - Country:US
Practice Address - Phone:678-432-3330
Practice Address - Fax:678-432-3662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA500341942IMedicaid
GA500341942EMedicaid