Provider Demographics
NPI:1962095356
Name:FIRST INTEGRATED COMMUNITY CARE SERVICES
Entity type:Organization
Organization Name:FIRST INTEGRATED COMMUNITY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:NAHOMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-914-5772
Mailing Address - Street 1:6624 JIMMY CARTER BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-1727
Mailing Address - Country:US
Mailing Address - Phone:770-281-9819
Mailing Address - Fax:770-284-4248
Practice Address - Street 1:6624 JIMMY CARTER BLVD STE A
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30071-1727
Practice Address - Country:US
Practice Address - Phone:770-281-9819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No347B00000XTransportation ServicesBus