Organization
LORRAINE DRIVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORRAINE DRIVER (CEO)
(770) 207-5300
Entity
Organization
Contact information
Practice address
120 2ND ST STE 105, MONROE, GA 30655-2391
(770) 207-5300
(888) 843-1625
Mailing address
PO BOX 1807, MONROE, GA 30655-6807
(770) 207-5300
(888) 843-1625
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
842788030B
—
GA
05
—
842788030C
—
GA
Enumeration date
07/31/2006
Last updated
12/07/2017
Update your record
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