MEDICARE: GBR@COMPANY

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1366393647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GBR@COMPANY

Provider Business Mailing Address
First Line	:	7180 SPRINGCHASE WAY
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30168-6322
Country	:	US
Telephone Number	:	678-458-8296
Fax Number	:

Provider Business Practice Location Address
First Line	:	7180 SPRINGCHASE WAY
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30168-6322
Country	:	US
Telephone Number	:	678-458-8296
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. GERRY BERNARD RICHARDSON
Credential	:	MSW
Telephone Number	:	678-458-8296

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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Directions to “GBR@COMPANY ” Practice Location

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