Provider Demographics
NPI:1730383134
Name:PROJECT ADVENTURE INC.
Entity type:Organization
Organization Name:PROJECT ADVENTURE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:770-784-9310
Mailing Address - Street 1:PO BOX 2447
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30015-7447
Mailing Address - Country:US
Mailing Address - Phone:770-784-9310
Mailing Address - Fax:770-787-7764
Practice Address - Street 1:396 ELKS CLUB RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-4036
Practice Address - Country:US
Practice Address - Phone:770-784-9310
Practice Address - Fax:770-787-7764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health