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General NPI Number Information
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NPI Number | 1285954156
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Entity Type | Organization
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Legal Business Name | GEORGIA MOUNTAINS COMMUNITY SERVICES
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 10-B HUGHES STREET
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3552
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Country | US
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Telephone | 706-745-5231
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Fax |
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Provider Business Mailing Address
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Address Line | 4331 THURMON TANNER RD
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City | FLOWERY BRANCH
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State | GA
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Zip | 30542-2829
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Country | US
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Telephone | 678-513-5762
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Fax |
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Authorized Official
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Title or Position | BUSINESS ANALYST
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Name | LORETTA JONES
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Credential |
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Telephone | 678-513-5762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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