Organization
GEORGIA MOUNTAINS COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN TUCKER (BILLING SPECIALIST)
(678) 689-9781
Entity
Organization
Contact information
Practice address
3509 MABRY RD, GAINESVILLE, GA 30504-5755
(770) 532-0304
Mailing address
4331 THURMON TANNER RD, FLOWERY BRANCH, GA 30542-2829
(678) 689-9781
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000607054AX
—
GA
Enumeration date
02/10/2011
Last updated
02/10/2011
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