NPI age
18 years
Enumerated 2008-01-09
Across 2449 active community/behavioral health providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00604469Z | |
| 01 (GA) | 815926000 | MAGELLAN MIS NUMBER |
Single-site organization. Only one practice location on file.
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