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NPI Code Detail

MEDICARE: ADDISON MANAGEMENT INC

MEDICARE: ADDISON MANAGEMENT INC
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
1251B00000XCase Management Agency
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1376979393
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADDISON MANAGEMENT INC
Provider Business Mailing Address
First Line : PO BOX 1228
Second Line :
City : STOCKBRIDGE
State : GA
Zip : 30281-8228
Country : US
Telephone Number : 404-259-1451
Fax Number :
Provider Business Practice Location Address
First Line : 240 CORPORATE CENTER DR
Second Line : SUITE D
City : STOCKBRIDGE
State : GA
Zip : 30281-7214
Country : US
Telephone Number : 404-259-1451
Fax Number : 678-601-1564
Authorized Official
Title or Position : MANAGING PARTNER
Name : MS. VERONICA L ADDISON
Credential :
Telephone Number : 404-259-1451
Provider Enumeration Date : 09/23/2013
Last Update Date : 09/23/2013

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