OrganizationActive
Positive Impact Residential Services
NPI 1487079562 · Mental Health Clinic/Center (Including Community Mental Health Center) · Decatur, GA
Provider details
- NPI number
- 1487079562
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Wax Flowers, Lcsw/Owner(866) 730-7604
- License
- CSW002378 (GA)
Specialties & taxonomies
- Mental Health Clinic/Center (Including Community Mental Health Center)Primary261QM0801XLicense CSW002378 (GA)
Ambulatory Health Care Facilities
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2189 W Ponce De Leon Ave
Decatur, GA 30030-2334
Phone: (678) 887-3263
Fax: (404) 687-9871
Street-level locationGet directions
Mailing address
2189 W Ponce De Leon Ave
Decatur, GA 30030-2334
Registry dates
- Enumerated
- 2014-02-25
- Last updated
- 2014-02-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.