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General NPI Number Information
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NPI Number | 1407084387
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Entity Type | Organization
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Legal Business Name | HIGHLAND RIVERS CENTER CSB
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 06/30/2009
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Provider Practice Location Address
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Address Line | 1620 HICKORY ST SUITE 408
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City | DALTON
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State | GA
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Zip | 30720-2312
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Country | US
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Telephone | 706-270-5003
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Fax | 706-370-7749
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Provider Business Mailing Address
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Address Line | 1620 HICKORY ST SUITE 408
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City | DALTON
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State | GA
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Zip | 30720-2312
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Country | US
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Telephone | 706-270-5003
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Fax | 706-370-7749
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Authorized Official
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Title or Position | CEO
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Name | MR. FRANK AARON
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Credential |
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Telephone | 706-270-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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