NPI age
19 years
Enumerated 2007-03-12
Across 495 active case management providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 300036015B | MEDICAID PAVEE # |
| 05 (GA) | 8550800G |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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