Organization
COMMUNITY GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALINDA A LOGAN-PETERS CPPM (REVENUE MANAGER)
(731) 935-9267
Entity
Organization
Contact information
Practice address
1542 OAKLEAF DR, AUBURN, GA 30011-3268
(470) 905-2549
(877) 540-0067
Mailing address
1415 HIGHWAY 85 N, FAYETTEVILLE, GA 30214-7738
(470) 905-2549
(877) 540-0067
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/04/2023
Last updated
09/04/2023
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