# DEKALB COUNTY BOARD OF HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** East Teen Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750488052
- **Authorized official:** SANDRA E BOUCHELION MD (DISTRICT DIRECTOR/CEO)
- **Authorized official phone:** (404) 294-3787

## Contact information

- **Practice address:** 2612 MAX CLELAND BLVD STE A, LITHONIA, GA 30058-4400
- **Practice address phone:** (678) 526-5429
- **Practice address fax:** (678) 526-5434
- **Mailing address:** 445 WINN WAY, PO BOX 987, DECATUR, GA 30030-1707
- **Mailing address phone:** (404) 294-3701
- **Mailing address fax:** (404) 508-7862

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/22/2020