Organization
ABHS SUPPORTED EMP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN BUTLER (BILLING SUPERVISOR)
(706) 227-7250
Entity
Organization
Contact information
Practice address
250 NORTH AVE, ATHENS, GA 30601-2244
(706) 227-7250
(706) 227-7249
Mailing address
250 NORTH AVE, ATHENS, GA 30601-2244
(706) 227-7250
(706) 227-7249
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000631562N
—
GA
Enumeration date
01/17/2007
Last updated
06/13/2008
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