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General NPI Number Information
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NPI Number | 1205656535
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Entity Type | Organization
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Legal Business Name | THE MORTON LEGACY CENTER, LLC
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 500 LANIER AVE W STE 601
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7644
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Country | US
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Telephone | 404-213-0532
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Fax | 678-653-8562
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Provider Business Mailing Address
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Address Line | PO BOX 1631
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City | MARIETTA
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State | GA
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Zip | 30061-1631
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Country | US
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Telephone | 404-213-0532
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Fax | 678-653-8562
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Authorized Official
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Title or Position | PRESIDENT/FOUNDER/INVESTIGATOR
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Name | MS. MONICA MORTON
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Credential |
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Telephone | 404-213-0532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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