Organization
CHILDRENS HEALTHCARE OF ATLANTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN TAYLOR RN (ASSISTANT MANAGER)
(404) 785-1882
Entity
Organization
Contact information
Practice address
494 RISING SUN PATH, LAWRENCEVILLE, GA 30043-3169
(770) 338-7476
(770) 338-7476
Mailing address
494 RISING SUN PATH, LAWRENCEVILLE, GA 30043-3169
(770) 338-7476
(770) 338-7476
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
RN158875
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XKH511A63954-01
BLUE CROSS/ BLUE SHIELD
GA
Enumeration date
07/21/2008
Last updated
07/21/2008
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