| Choices For Life Of Georgia, Llc | |
|
2080 Sugarloaf Pkwy Lawrenceville GA 30045-9401 | |
| (706) 494-1821 | |
| (706) 494-1989 |
| Full Name | Choices For Life Of Georgia, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2080 Sugarloaf Pkwy, Lawrenceville, Georgia |
| Authorized Official Name and Position | Douglas Charles Fellrath (CEO) |
| Authorized Official Contact | 4057510800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Choices For Life Of Georgia, Llc 2080 Sugarloaf Pkwy Lawrenceville GA 30045-9401 Ph: (706) 494-1821 | Choices For Life Of Georgia, Llc 2080 Sugarloaf Pkwy Lawrenceville GA 30045-9401 Ph: (706) 494-1821 |
| NPI Number | 1437395860 |
|---|---|
| Provider Enumeration Date | 01/07/2009 |
| Last Update Date | 01/07/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437395860 | NPI | - | NPPES |
| 001462443A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CPFC001072 (Georgia) | Primary |
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