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General NPI Number Information
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NPI Number | 1912246406
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Entity Type | Organization
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Legal Business Name | AMERICAN FAMILY CARE NETWORK OF GEORGIA
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 1514 CLEVELAND AVE SUITE 120
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City | EAST POINT
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State | GA
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Zip | 30344-6965
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Country | US
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Telephone | 919-423-2277
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 CLEVELAND AVE SUITE 120
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City | EAST POINT
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State | GA
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Zip | 30344-6965
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Country | US
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Telephone | 919-423-2277
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | CORY TITO FRANCIS
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Credential |
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Telephone | 919-423-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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