Organization
PROFESSIONAL ASSOCIATES HEALTH CARE OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGNEAU JEAN-SIMON (STAFF)
(770) 865-5073
Entity
Organization
Contact information
Practice address
310 IVANHOE DR, FAYETTEVILLE, GA 30215-2041
(770) 461-9228
(770) 461-9228
Mailing address
316 S 9TH ST, GRIFFIN, GA 30224-4159
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
932102913
GA
Other
Enumeration date
11/02/2010
Last updated
03/14/2024
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