| 111 Dui School | |
|
2245 Godby Rd Suite 102 & 104 College Park GA 30349-5059 | |
| (404) 996-4286 | |
| Not Available |
| Full Name | 111 Dui School |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2245 Godby Rd, College Park, Georgia |
| Authorized Official Name and Position | Felicia Rose Perry (DIRECTOR) |
| Authorized Official Contact | 4049964286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 111 Dui School 2245 Godby Rd Suite 102 & 104 College Park GA 30349-5059 Ph: (404) 996-4286 | 111 Dui School 2245 Godby Rd Suite 102 & 104 College Park GA 30349-5059 Ph: (404) 996-4286 |
| NPI Number | 1124451570 |
|---|---|
| Provider Enumeration Date | 08/20/2013 |
| Last Update Date | 08/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124451570 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC007314 (Georgia) | Primary |
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