Organization
CHRIS 180, INC.
Active
Other names
North Fulton Service Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN JAMES BELLOR BBA, NP, PA, AASEET (CLINIC ADMINISTRATOR)
(404) 486-9034
Entity
Organization
Contact information
Practice address
7741 ROSWELL RD STE B, ATLANTA, GA 30350-4845
(404) 486-9034
(404) 835-9350
Mailing address
1017 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2932
(404) 486-9034
(404) 835-9650
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300023628A
—
GA
05
—
640804505M
—
GA
Enumeration date
03/30/2019
Last updated
06/11/2019
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