Organization
GEORGIA MOUNTAIN COMMUNITY SERVICES
Active
Other names
Avita Community Partners
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY THOMPSON (BILLING SPECIALIST)
(678) 513-5720
Entity
Organization
Contact information
Practice address
200 TOMAHAWK DR, CLARKESVILLE, GA 30523-3364
(678) 513-5720
(678) 513-5836
Mailing address
4331 THURMOND TANNER PARKWAY, FLOWERY BRANCH, GA 30542-2829
(678) 513-5720
(678) 513-5836
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000607054CB
RESIDENTIAL HOME
GA
Enumeration date
07/10/2012
Last updated
07/10/2012
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