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General NPI Number Information
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NPI Number | 1427259027
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Entity Type | Organization
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Legal Business Name | ADAPT GEORGIA
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 440 RALPH MCGILL BLVD NE
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City | ATLANTA
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State | GA
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Zip | 30312-1217
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Country | US
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Telephone | 404-418-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 2203 BRANDON LN SW
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City | CONYERS
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State | GA
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Zip | 30094-5090
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Country | US
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Telephone | 770-785-5045
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. DANIEL TRUSSELL
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Credential | PH.D.
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Telephone | 404-418-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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