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General NPI Number Information
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NPI Number | 1043549686
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Entity Type | Organization
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Legal Business Name | NORTH GEORGIA CHILDREN'S CENTER, INC.
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Dates
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Enumeration Date | 12/10/2009
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Last Update Date | 12/10/2009
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Provider Practice Location Address
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Address Line | 1575 DAHLONEGA HWY
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City | CUMMING
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State | GA
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Zip | 30040-4528
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Country | US
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Telephone | 770-844-8664
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Fax | 770-844-8643
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Provider Business Mailing Address
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Address Line | PO BOX 38
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City | CUMMING
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State | GA
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Zip | 30028-0038
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Country | US
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Telephone | 770-844-8664
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Fax | 770-844-8643
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JESSICA L PUGH
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Credential | MS, BCBA
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Telephone | 770-844-8664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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