Organization
THE ELIM COMMUNITY DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSBORNE J GILES SR. (CEO)
(470) 658-9284
Entity
Organization
Contact information
Practice address
4717 COVINGTON HWY, SUITE 109, DECATUR, GA 30035-2015
(470) 658-9284
Mailing address
2714 WATERFORD CLUB DR, LITHIA SPRINGS, GA 30122-4413
(470) 658-9284
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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