Chris 180, Inc. | |
2805 Metropolitan Pkwy Sw Atlanta GA 30315-7915 | |
(404) 486-9034 | |
(404) 835-9350 |
Full Name | Chris 180, Inc. |
---|---|
Speciality | Community/behavioral Health |
Location | 2805 Metropolitan Pkwy Sw, Atlanta, Georgia |
Authorized Official Name and Position | Dan James Bellor (CLINIC ADMINISTRATOR) |
Authorized Official Contact | 4044869034 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Chris 180, Inc. 1017 Fayetteville Rd Se Atlanta GA 30316-2932 Ph: (404) 486-9034 | Chris 180, Inc. 2805 Metropolitan Pkwy Sw Atlanta GA 30315-7915 Ph: (404) 486-9034 |
NPI Number | 1770044810 |
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Provider Enumeration Date | 03/30/2019 |
Last Update Date | 06/11/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770044810 | NPI | - | NPPES |
640804505L | Medicaid | GA | |
300023628A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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