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Organization

FAITH HEALTH SERVICES OF GA.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FAITH HERMA VICKERIE R.N. (CEO)
(770) 598-8031
Entity
Organization

Contact information

Practice address
240 PROSPECT PL, ALPHARETTA, GA 30005-5454
(678) 624-1646
(770) 442-3320
Mailing address
240 PROSPECT PL, ALPHARETTA, GA 30005-5454
(678) 624-1646
(770) 442-3320

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000696935G
GA
05
703485909A
GA
Enumeration date
12/28/2010
Last updated
12/28/2010
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