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General NPI Number Information
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NPI Number | 1043009483
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Entity Type | Organization
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Legal Business Name | NEW CHANCE CENTERS LLC
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 2733 SHERATON DR STE 110
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City | MACON
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State | GA
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Zip | 31204-6850
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Country | US
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Telephone | 478-202-7273
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Fax | 478-239-0094
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Provider Business Mailing Address
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Address Line | 7015 POLO DR
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City | CUMMING
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State | GA
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Zip | 30040-7008
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Country | US
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Telephone | 770-842-1379
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. AARON ERDMAN
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Credential |
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Telephone | 478-202-7273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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