Provider Demographics
NPI:1548497233
Name:HELPING OUT PEOPLE ENVIRONMENTS
Entity type:Organization
Organization Name:HELPING OUT PEOPLE ENVIRONMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JIMESE
Authorized Official - Middle Name:ALEXIA
Authorized Official - Last Name:LIGHTFOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-238-6269
Mailing Address - Street 1:1776 TWIN PINES DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-1235
Mailing Address - Country:US
Mailing Address - Phone:478-238-6269
Mailing Address - Fax:
Practice Address - Street 1:1776 TWIN PINES DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-1235
Practice Address - Country:US
Practice Address - Phone:478-238-6269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA657967178AMedicaid