Provider Demographics
NPI:1194437483
Name:EDUCARE COLLABORATIVE LLC
Entity type:Organization
Organization Name:EDUCARE COLLABORATIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:IRWIN-COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-988-6835
Mailing Address - Street 1:152 SOUTHGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:152 SOUTHGATE BLVD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8035
Practice Address - Country:US
Practice Address - Phone:678-988-6835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No302R00000XManaged Care OrganizationsHealth Maintenance Organization