Provider Demographics
NPI:1447814173
Name:CSA HEALTHCARE PROFESSIONALS
Entity type:Organization
Organization Name:CSA HEALTHCARE PROFESSIONALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-CEO/DON
Authorized Official - Prefix:
Authorized Official - First Name:RYKEYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:470-301-9510
Mailing Address - Street 1:2224 JENNY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-4532
Mailing Address - Country:US
Mailing Address - Phone:470-301-9510
Mailing Address - Fax:
Practice Address - Street 1:14303 PROVIDENCE CIR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-7132
Practice Address - Country:US
Practice Address - Phone:470-301-9510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care