Organization
FAMILY ART THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN ROSE REDD (OFFICE MANAGER)
(706) 782-0717
Entity
Organization
Contact information
Practice address
44 COTTONWOOD ST., CLAYTON, GA 30525
(706) 782-0717
(706) 782-5266
Mailing address
44 COTTONWOOD ST., CLAYTON, GA 30525
(706) 782-0717
(706) 782-5266
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC4008
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10045587
AMERIGROUP
GA
Enumeration date
02/14/2007
Last updated
08/22/2020
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