Provider Demographics
NPI:1861299711
Name:COMMUNITY OUTREACH PREVENTATIVE CARE INC (COPC)
Entity type:Organization
Organization Name:COMMUNITY OUTREACH PREVENTATIVE CARE INC (COPC)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-979-5091
Mailing Address - Street 1:1920 MONROE DR NE STE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4880
Mailing Address - Country:US
Mailing Address - Phone:419-824-5203
Mailing Address - Fax:419-318-4395
Practice Address - Street 1:1920 MONROE DR NE STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4880
Practice Address - Country:US
Practice Address - Phone:419-824-5203
Practice Address - Fax:419-318-4395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty