Organization
JD WALLACE ENTERPRISES
Active
Other names
Family Health Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DAVID WALLACE (CEO)
(323) 558-2797
Entity
Organization
Contact information
Practice address
4286 MEMORIAL DR STE C, SUITE B, DECATUR, GA 30032-1221
(404) 499-0342
(678) 928-9427
Mailing address
PO BOX 43381, ATLANTA, GA 30349
(323) 558-2797
(678) 928-9427
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/06/2010
Last updated
07/25/2013
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