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General NPI Number Information
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NPI Number | 1023964426
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Entity Type | Organization
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Legal Business Name | BLUE ABA GEORGIA LLC
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 260 PEACHTREE ST NW STE 2200
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City | ATLANTA
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State | GA
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Zip | 30303-1292
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Country | US
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Telephone | 404-282-8935
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Fax | 623-748-1919
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Provider Business Mailing Address
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Address Line | 260 PEACHTREE ST NW STE 2200
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City | ATLANTA
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State | GA
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Zip | 30303-1292
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Country | US
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Telephone | 404-282-8935
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Fax | 623-748-1919
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Authorized Official
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Title or Position | MANAGER
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Name | GERSHON FINK
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Credential | DO
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Telephone | 786-521-1587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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