Organization
GA DEPARTMENT OF HUMAN RESOURCES
Active
Other names
Georgia Regional Hospital at Atlanta
Organization subpart
No
Provider details
NPI number
Authorized official
SONNY SLATE COO (CHIEF OPERATIONS OFFICER)
(404) 243-2121
Entity
Organization
Contact information
Practice address
3073 PANTHERSVILLE ROAD, DECATUR, GA 30034-3828
(404) 243-2158
(404) 243-2159
Mailing address
P.O. BOX 370407, DECATUR, GA 30034-3828
(404) 212-5454
(404) 243-2159
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
044-232
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00141061A
—
GA
Enumeration date
06/13/2006
Last updated
05/12/2010
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