Organization
GRN COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL HADEN RAPER M.ED., M.S. (CSI COUNSELOR)
(770) 638-5760
Entity
Organization
Contact information
Practice address
5030 GEORGIA BELLE CT, STE 2036, NORCROSS, GA 30093-2667
(770) 638-5760
(770) 638-5789
Mailing address
3432 WATER VISTAS PKWY, APT. B, LAWRENCEVILLE, GA 30044-3070
(770) 381-5498
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/14/2006
Last updated
08/22/2020
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