Organization Name: | GEORGIA MOUNTAINS COMMUNITY SERVICES |
NPI Number: | 1316057342 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN R TUCKER (BILLING MANAGER) |
Mailing Address: | 150 Johnson St Dahlonega |
State: | GA US |
Postal Code: | 305330501 |
Phone Number: | 7068646822 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 02/05/2008 |
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: |