Provider Demographics
NPI:1437712122
Name:WISH YOU WELL YOUTH FAITH FOUNDATION INC
Entity type:Organization
Organization Name:WISH YOU WELL YOUTH FAITH FOUNDATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARMON
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-783-9297
Mailing Address - Street 1:9456 S MAIN ST STE D4
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-6074
Mailing Address - Country:US
Mailing Address - Phone:678-783-9297
Mailing Address - Fax:
Practice Address - Street 1:9456 S MAIN ST STE D4
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-6074
Practice Address - Country:US
Practice Address - Phone:678-783-9297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)Group - Single Specialty
No171W00000XOther Service ProvidersContractorGroup - Single Specialty
No305S00000XManaged Care OrganizationsPoint of ServiceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA46-4625337OtherSHARJ'S SPECIAL TOUCH PAINTING & INTERIOR DESIGN LLC