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General NPI Number Information
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NPI Number | 1710012018
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Entity Type | Organization
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Legal Business Name | CARE AND COUNSELING CENTER OF GEORGIA, INC.
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 1814 CLAIRMONT RD
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City | DECATUR
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State | GA
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Zip | 30033-3405
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Country | US
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Telephone | 404-636-1457
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Fax | 404-636-7449
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Provider Business Mailing Address
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Address Line | 1814 CLAIRMONT RD
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City | DECATUR
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State | GA
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Zip | 30033-3405
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Country | US
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Telephone | 404-636-1457
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Fax | 404-636-7449
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SANDRA A MULLINS
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Credential | REVEREND
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Telephone | 404-636-1457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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