| Organization Name: | BURNING BUSH YOUTH & FAMILY INTERVENTION CENTER, INC. |
| NPI Number: | 1992047278 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONALD TINSLEY (EXECUTIVE DIRECTOR) |
| Mailing Address: | 144 Brookwood Ave Jackson |
| State: | GA US |
| Postal Code: | 302331403 |
| Phone Number: | 6787748230 |
| Fax Number: | 6787748233 |
| NPI Enumeration Date: | 03/25/2013 |
| NPI Last Update Date: | 03/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |