Organization
GEORGIA MOUNTAIN COMMUNITY SERVICES
Active
Other names
Avita Community Partners
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN R TUCKER (BILLING MANAGER)
(678) 513-5733
Entity
Organization
Contact information
Practice address
154 HART SERVICE RD, HARTWELL, GA 30643-8440
(678) 513-5700
(678) 513-5700
Mailing address
4331 THURMON TANNER RD, FLOWERY BRANCH, GA 30542-2829
(678) 513-5762
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000624731AI
—
GA
Enumeration date
12/18/2006
Last updated
06/25/2010
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