Organization
CHRIS 180, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN JAMES BELLOR (CLINIC ADMINISTRATOR)
(404) 486-9034
Entity
Organization
Contact information
Practice address
2805 METROPOLITAN PKWY SW, ATLANTA, GA 30315-7915
(404) 486-9034
(404) 835-9350
Mailing address
1017 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2932
(404) 486-9034
(404) 835-9350
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300023628A
—
GA
05
—
640804505L
—
GA
Enumeration date
03/30/2019
Last updated
06/11/2019
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