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General NPI Number Information
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NPI Number | 1174466577
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HEALTHCARE CENTER, LLC
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Dates
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Enumeration Date | 04/10/2026
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Last Update Date | 04/10/2026
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Provider Practice Location Address
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Address Line | 510 WASHINGTON AVE
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City | SANDERSVILLE
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State | GA
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Zip | 31082-1971
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Country | US
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Telephone | 478-412-6522
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Fax | 478-412-6521
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Provider Business Mailing Address
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Address Line | 510 WASHINGTON AVE
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City | SANDERSVILLE
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State | GA
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Zip | 31082-1971
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Country | US
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Telephone | 478-412-6522
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Fax | 478-412-6521
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. CHRISTY M MOUNTAIN-BONNER
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Credential | MD
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Telephone | 678-772-1259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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