Provider Demographics
NPI:1063170694
Name:LEARNING SERVICES GEORGIA, LLC
Entity type:Organization
Organization Name:LEARNING SERVICES GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DEVELOPMENT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:SWICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLP
Authorized Official - Phone:269-986-0420
Mailing Address - Street 1:131 LANGLEY DR STE B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-6909
Mailing Address - Country:US
Mailing Address - Phone:888-419-9955
Mailing Address - Fax:
Practice Address - Street 1:11180 CRABAPPLE RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2404
Practice Address - Country:US
Practice Address - Phone:678-277-9275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEARNING SERVICES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care