Organization
CASSANDRA GILLIAM
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CASSANDRA SHEA GILLIAM RN (RN)
(404) 294-0499
Entity
Organization
Contact information
Practice address
450 WINN WAY, DECATUR, GA 30030-1715
(404) 294-0499
Mailing address
3850 EDEN GLEN DR SE, CONYERS, GA 30013-5813
(770) 679-4366
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
RN171251
GA
Other
Enumeration date
04/19/2007
Last updated
08/22/2020
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