Organization
CG&D ADDICTION SERVICES OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA G. COOPER LPC, CASAC (PROGRAM DIRECTOR/NY)
(631) 691-0769
Entity
Organization
Contact information
Practice address
4540 MEMORIAL DR, BLDG D, DECATUR, GA 30032-1499
(404) 292-8175
(404) 292-8180
Mailing address
4540 MEMORIAL DR, BLDG D, DECATUR, GA 30032-1499
(404) 292-8175
(404) 292-8180
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
044673D
GA
Other
Enumeration date
07/14/2008
Last updated
07/14/2008
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