Healthcare Provider Details

I. General information

NPI: 1952856254
Provider Name (Legal Business Name): CMSA OPTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OAKHURST DR
EVANS GA
30809-3711
US

IV. Provider business mailing address

3554 STEVENS WAY
MARTINEZ GA
30907-8901
US

V. Phone/Fax

Practice location:
  • Phone: 706-364-7430
  • Fax: 706-364-7854
Mailing address:
  • Phone: 706-364-7430
  • Fax: 706-364-7854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberADC000079
License Number StateGA

VIII. Authorized Official

Name: MS. DOROTHY ANN GRADY
Title or Position: CEO
Credential: RN
Phone: 706-364-7430