Organization
GEORGIA MOUNTAINS COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN R TUCKER (BILLING MANAGER)
(678) 513-5733
Entity
Organization
Contact information
Practice address
451 ROPER DR, CLARKESVILLE, GA 30523-6623
(678) 513-5700
(678) 513-5700
Mailing address
4331 THURMON TANNER RD, FLOWERY BRANCH, GA 30542-2829
(678) 513-5700
(678) 513-5700
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000607054AN
—
GA
Enumeration date
05/18/2010
Last updated
07/09/2010
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