Organization
GWINNETT, ROCKDALE & NEWTON COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA JO CALANDRINO M.S. M.H.P. CPRP (DAY SERVICES COORDINATOR)
(770) 995-6902
Entity
Organization
Contact information
Practice address
595 OLD NORCROSS RD STE C, LAWRENCEVILLE, GA 30045-7667
(770) 995-6902
Mailing address
595 OLD NORCROSS RD STE C, LAWRENCEVILLE, GA 30045-7667
(770) 995-6902
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
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