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Organization

PABS UNLIMITED, INC

Active
Other names
PABS FamilyCounselng and Intervention Services
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DWIGHT ALONZO PORTER L.P.C., ED.S. (THERAPIST)
(770) 969-4309
Entity
Organization

Contact information

Practice address
4405 MALL BLVD STE 200, UNION CITY, GA 30291-2071
(770) 969-4309
(770) 969-4170
Mailing address
4405 MALL BLVD STE 200, UNION CITY, GA 30291-2071
(770) 969-4309
(770) 969-4170

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
006366
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
49440073A
GA
Enumeration date
07/15/2013
Last updated
07/15/2013
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