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NPI 1003951088 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1003951088
Enumeration Date 02/20/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name GARY GARY
Position EXECUTIVE DIRECTOR
Phone (770) 938-3578
Fax (770) 938-3578
Practice Location
4316 SMITHSONIA DR
TUCKER GA, 30084-2615, US
Phone (770) 938-3578
Fax (770) 938-3578
Business Location
4316 SMITHSONIA DR
TUCKER GA, 30084-2615, US
Phone (770) 938-3578
Fax (770) 938-3578
Toxanomy
Taxonomy Code 251S00000X
License State
License Number
Remove 1003951088 NPI Number
 

According to our database, Cofer Group Home NPI is 1003951088, taxonomy code is 251S00000X Cofer Group Home physically located at 4316 Smithsonia Dr, Tucker GA, 30084-2615. NPI Number 1033115704 has the healthcare provider type.

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1003951088 NPI number is provided on an as is basis without warranty of any kind. 1003951088 is maintained by the National Plan & Provider Enumeration System. The contents of Cofer Group Home are for informational purposes only.