| Avita Community Partner | |
|
150a Johnson St Dahlonega GA 30533-0501 | |
| (706) 864-6822 | |
| Not Available |
| Full Name | Avita Community Partner |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 150a Johnson St, Dahlonega, Georgia |
| Authorized Official Name and Position | Douglas Sills (SSP1) |
| Authorized Official Contact | 7068646822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avita Community Partner 4331 Thurmon Tanner Rd Flowery Branch GA 30542-2829 Ph: (678) 513-5700 | Avita Community Partner 150a Johnson St Dahlonega GA 30533-0501 Ph: (706) 864-6822 |
| NPI Number | 1548403280 |
|---|---|
| Provider Enumeration Date | 04/10/2009 |
| Last Update Date | 04/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548403280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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