# DEPARTMENT OF VETERAN AFFAIRS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982154241
- **Authorized official:** MISS CYNTHIA REGINA COLLINS MSW (SOCIAL WORKER)
- **Authorized official phone:** (678) 442-8619

## Contact information

- **Practice address:** 1122 PROVIDENCE WAY, LAWRENCEVILLE, GA 30046-3316
- **Practice address phone:** (678) 442-8619
- **Mailing address:** 1122 PROVIDENCE WAY, LAWRENCEVILLE, GA 30046-3316
- **Mailing address phone:** (678) 442-8619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 10/11/2016
- **Last updated:** 10/11/2016