Provider Demographics
NPI:1063534725
Name:MCPHERSON TRAINING & DEVELOPMENT SERVICES, LLC
Entity type:Organization
Organization Name:MCPHERSON TRAINING & DEVELOPMENT SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:MCPHERSON
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, EDD
Authorized Official - Phone:678-945-6855
Mailing Address - Street 1:1220 HERITAGE LAKES DR SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-1248
Mailing Address - Country:US
Mailing Address - Phone:678-945-6855
Mailing Address - Fax:678-945-6856
Practice Address - Street 1:1220 HERITAGE LAKES DR SW
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-1248
Practice Address - Country:US
Practice Address - Phone:678-945-6855
Practice Address - Fax:678-945-6856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-0111251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care