NPI age
17 years
Enumerated 2009-02-18
Across 2449 active community/behavioral health providers in Georgia.
7 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 9489135 | AETNA |
| 05 (GA) | 328478934C | |
| 05 (GA) | 345107105A | |
| 01 | 436910 | MANAGED HEALTHCARE NETWORK |
| 01 | 11855418 | CAQH |
Multi-provider organization. 7 individual providers on file at this primary address.
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