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General NPI Number Information
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NPI Number | 1174958706
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Entity Type | Organization
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Legal Business Name | CORRECTIONAL MEDICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 1000 CIRCLE 75 PKWY SE SUITE 060
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City | ATLANTA
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State | GA
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Zip | 30339-3026
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Country | US
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Telephone | 404-760-0296
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Fax | 404-760-0298
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Provider Business Mailing Address
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Address Line | 1000 CIRCLE 75 PKWY SE SUITE 060
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City | ATLANTA
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State | GA
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Zip | 30339-3026
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Country | US
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Telephone | 404-760-0296
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Fax | 404-760-0298
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. FELICIA GARRETT HERRING
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Credential |
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Telephone | 404-760-0296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | J702424
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License Number State | GA
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