MEDICARE: CHILD AND FAMILY FOCUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1255567111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILD AND FAMILY FOCUS

Provider Business Mailing Address
First Line	:	133 SAMARITAN DR
Second Line	:	SUITE 303
City	:	CUMMING
State	:	GA
Zip	:	30040-2396
Country	:	US
Telephone Number	:	770-833-1055
Fax Number	:	877-498-0462

Provider Business Practice Location Address
First Line	:	133 SAMARITAN DR
Second Line	:	SUITE 303
City	:	CUMMING
State	:	GA
Zip	:	30040-2396
Country	:	US
Telephone Number	:	770-833-1055
Fax Number	:	877-498-0462

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. JENNY WOOD
Credential	:	LPC
Telephone Number	:	770-833-1055

Provider Enumeration Date	:	06/05/2009
Last Update Date	:	06/05/2009

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Directions to “CHILD AND FAMILY FOCUS ” Practice Location

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