Provider Demographics
NPI:1063386340
Name:DENALI COMMUNITY SERVICES, LLC
Entity type:Organization
Organization Name:DENALI COMMUNITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:GODWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-886-8125
Mailing Address - Street 1:7446 COVINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-7612
Mailing Address - Country:US
Mailing Address - Phone:470-886-8125
Mailing Address - Fax:678-476-1699
Practice Address - Street 1:1274 ROCK CHAPEL RD
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-5833
Practice Address - Country:US
Practice Address - Phone:706-459-1875
Practice Address - Fax:678-476-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care