Organization
CITYSIDE HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OMAR U. GREEN (CEO)
(404) 557-7186
Entity
Organization
Contact information
Practice address
4502 PARKVIEW SQ, ATLANTA, GA 30349-9408
(404) 768-0440
(404) 768-0412
Mailing address
950 DANNON VW SW, SUITE 4103, ATLANTA, GA 30331-2160
(404) 557-7186
(404) 941-2657
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Enumeration date
11/27/2009
Last updated
09/26/2012
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