Healthcare Provider Details

I. General information

NPI: 1770627515
Provider Name (Legal Business Name): FAMILY AND CHILDREN FIRST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 DUG GAP RD
DALTON GA
30720-5007
US

IV. Provider business mailing address

PO BOX 863
DALTON GA
30722-0863
US

V. Phone/Fax

Practice location:
  • Phone: 706-279-0405
  • Fax: 706-279-4190
Mailing address:
  • Phone: 706-279-0405
  • Fax: 706-279-4190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateGA

VIII. Authorized Official

Name: MRS. SONJA EARLY
Title or Position: VP OF ADMINISTRATION
Credential:
Phone: 706-279-0405