Organization
SUMMITRIDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW CAUDILL LCSW (ASSESSMENT CSLR)
(678) 312-5850
Entity
Organization
Contact information
Practice address
250 SCENIC HWY, LAWRENCEVILLE, GA 30045-5675
(678) 312-3585
(678) 312-5915
Mailing address
250 SCENIC HWY, LAWRENCEVILLE, GA 30045-5675
(678) 312-3585
(678) 312-5915
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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