Provider Demographics
NPI:1336925718
Name:SKANDALAKIS & CARROLL, LLC
Entity type:Organization
Organization Name:SKANDALAKIS & CARROLL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:SKANDALAKIS
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:404-990-0302
Mailing Address - Street 1:6080 HEARDS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3633
Mailing Address - Country:US
Mailing Address - Phone:404-990-0302
Mailing Address - Fax:404-943-9939
Practice Address - Street 1:6080 HEARDS CREEK DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3633
Practice Address - Country:US
Practice Address - Phone:404-990-0302
Practice Address - Fax:404-943-9939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services