Organization
IRIE'S COMMUNITY DEVELOPMENT CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY J TOWNS (PRESIDENT/OWNER)
(478) 353-8500
Entity
Organization
Contact information
Practice address
112 MALL RD, DUBLIN, GA 31021-3035
(404) 835-3215
(404) 835-3217
Mailing address
5495 OLD NATIONAL HWY STE C1, COLLEGE PARK, GA 30349-3256
(470) 357-2561
(470) 357-2564
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003140721A
—
GA
05
—
003143622A
—
GA
05
—
003204906A
—
GA
05
—
003204906B
—
GA
Enumeration date
09/06/2010
Last updated
03/21/2019
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