Organization
SANTA ROSA CLINIC, PA
Active
Parent organization
SANTA ROSA CLINIC, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
SANTA ROSA CLINIC, PA
Authorized official
DR. JUAN CARLOS MALPARTIDA MD (OWNER)
(706) 259-5579
Entity
Organization
Contact information
Practice address
355 RICHARDSON RD SE STE 6, CALHOUN, GA 30701-3681
(706) 625-2237
(706) 625-2239
Mailing address
355 RICHARDSON RD SE STE 6, CALHOUN, GA 30701-3681
(706) 625-2237
(706) 625-2239
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
50406
GA
261QA0600X
Adult Day Care Clinic/Center
53528
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342515362A
—
GA
05
—
849865610-A
—
GA
Enumeration date
02/02/2009
Last updated
02/02/2009
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