Organization
GANG BREAKER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARRISON TARSHEEN PETERS (FOUNDER/CEO)
(404) 916-4538
Entity
Organization
Contact information
Practice address
2200 WILLOW TRAIL PKWY, NORCROSS, GA 30093-2525
(404) 916-4538
Mailing address
PO BOX 48661, ATLANTA, GA 30362-1661
(404) 916-4538
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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