Provider Demographics
NPI:1992128995
Name:NEW PROGRESSIONS OF GEORGIA, LLC
Entity type:Organization
Organization Name:NEW PROGRESSIONS OF GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOVON
Authorized Official - Middle Name:K
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-254-6770
Mailing Address - Street 1:1298 ROCKBRIDGE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3000
Mailing Address - Country:US
Mailing Address - Phone:336-254-6770
Mailing Address - Fax:
Practice Address - Street 1:1298 ROCKBRIDGE RD
Practice Address - Street 2:SUITE D
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3000
Practice Address - Country:US
Practice Address - Phone:336-254-6770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health