Organization Name: | GEORGIA MOUNTAIN COMMUNITY SVCS |
NPI Number: | 1265702013 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHELLE EVIE MILLER (BILLING SPECIALIST) |
Mailing Address: | 4331 Thurmond Tanner Pkwy Flowery Branch |
State: | GA US |
Postal Code: | 305422829 |
Phone Number: | 6785135700 |
Fax Number: | 6785135836 |
NPI Enumeration Date: | 01/11/2012 |
NPI Last Update Date: | 01/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |