Provider Demographics
NPI:1447941885
Name:ATVL LLC
Entity type:Organization
Organization Name:ATVL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARROCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-805-5134
Mailing Address - Street 1:2630 CALADIUM DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-1352
Mailing Address - Country:US
Mailing Address - Phone:470-635-9499
Mailing Address - Fax:
Practice Address - Street 1:2630 CALADIUM DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-1352
Practice Address - Country:US
Practice Address - Phone:470-635-9499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty