Organization
AVITA COMMUNITY PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN TUCKER (BILLING DEPARTMENT)
(678) 513-5700
Entity
Organization
Contact information
Practice address
4331 THURMON TANNER RD, FLOWERY BRANCH, GA 30542-2829
(678) 513-5700
Mailing address
4331 THURMON TANNER RD, FLOWERY BRANCH, GA 30542-2829
(678) 513-5700
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
RN071643
GA
Other
Enumeration date
04/06/2009
Last updated
04/06/2009
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