Organization
COMMUNITY TEEN COALITION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINIC STOKES (FOUNDER/CEO)
(678) 438-5051
Entity
Organization
Contact information
Practice address
6035 BROOKSIDE OAK CIR, NORCROSS, GA 30093-1754
(404) 931-2911
Mailing address
403 HIGHWAY 74 N, SUITE F, PEACHTREE CITY, GA 30269-3963
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
07063025
GA
Other
Enumeration date
01/16/2017
Last updated
01/16/2017
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