Organization
COBB COMMUNITY SERVICES BOARD
Active
Other names
Annette Carter Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOD CITRON LCSW (CEO)
(770) 429-5000
Entity
Organization
Contact information
Practice address
218 SOUTH AVE SE, MARIETTA, GA 30060-2384
(770) 429-5020
(678) 213-1450
Mailing address
3830 S COBB DR SE, SUITE 300, SMYRNA, GA 30080-5532
(770) 429-5020
(678) 213-1450
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000599783Q
—
GA
Enumeration date
01/15/2013
Last updated
01/15/2013
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