Organization
GEORGIA MOUNTAIN COMMUNITY PARTNERS
Active
Other names
Avita Community Partners
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY WEYNETTE THOMPSON (BILLING SPECIALIST)
(678) 513-5720
Entity
Organization
Contact information
Practice address
2059 GARDEN RD, GAINESVILLE, GA 30507-5019
(678) 513-5720
Mailing address
4331 THURMOND TANNER PARKWAY, FLOWERY BRANCH, GA 30542-2829
(678) 513-5720
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000607054CC
PROVIDER NUMBER
GA
Enumeration date
12/19/2012
Last updated
12/19/2012
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