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General NPI Number Information
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NPI Number | 1952856254
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Entity Type | Organization
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Legal Business Name | CMSA OPTIONS, LLC
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 801 OAKHURST DR
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City | EVANS
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State | GA
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Zip | 30809-3711
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Country | US
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Telephone | 706-364-7430
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Fax | 706-364-7854
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Provider Business Mailing Address
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Address Line | 3554 STEVENS WAY
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City | MARTINEZ
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State | GA
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Zip | 30907-8901
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Country | US
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Telephone | 706-364-7430
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Fax | 706-364-7854
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Authorized Official
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Title or Position | CEO
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Name | MS. DOROTHY ANN GRADY
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Credential | RN
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Telephone | 706-364-7430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | ADC000079
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License Number State | GA
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