Organization
CHC FULTON CMHC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM BRADLEY ROUSE (OFFICER)
(615) 376-6200
Entity
Organization
Contact information
Practice address
495 WINN WAY, SUITE 120, DECATUR, GA 30030-1736
(404) 389-0077
Mailing address
750 OLD HICKORY BLVD, 2-100, BRENTWOOD, TN 37027-4528
(615) 376-6200
(615) 376-6150
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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