Provider Demographics
NPI:1366225039
Name:FOUNDATION OF EXCEPTIONAL ACHIEVERS, INC.
Entity type:Organization
Organization Name:FOUNDATION OF EXCEPTIONAL ACHIEVERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-356-9626
Mailing Address - Street 1:2305 W PARK PLACE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3587
Mailing Address - Country:US
Mailing Address - Phone:678-356-9626
Mailing Address - Fax:
Practice Address - Street 1:2305 W PARK PLACE BLVD STE A
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3587
Practice Address - Country:US
Practice Address - Phone:678-356-9626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services