Organization
LOCKHART-TERRY FOUNDATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA EVETTE LOCKHART (ANGER MANAGEMNET SPECIALIST)
(678) 365-5611
Entity
Organization
Contact information
Practice address
3015 RAINBOW DR, SUITE 200, DECATUR, GA 30034-1668
(678) 365-5611
Mailing address
4969 CENTRAL DR APT C125, STONE MOUNTAIN, GA 30083-2003
(678) 365-5611
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Enumeration date
07/15/2013
Last updated
07/15/2013
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