| Community Teen Coalition, Inc | |
|
6035 Brookside Oak Cir Norcross GA 30093-1754 | |
| (404) 931-2911 | |
| Not Available |
| Full Name | Community Teen Coalition, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6035 Brookside Oak Cir, Norcross, Georgia |
| Authorized Official Name and Position | Dominic Stokes (FOUNDER/CEO) |
| Authorized Official Contact | 6784385051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Teen Coalition, Inc 403 Highway 74 N Suite F Peachtree City GA 30269-3963 Ph: () - | Community Teen Coalition, Inc 6035 Brookside Oak Cir Norcross GA 30093-1754 Ph: (404) 931-2911 |
| NPI Number | 1063958973 |
|---|---|
| Provider Enumeration Date | 01/16/2017 |
| Last Update Date | 01/16/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063958973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 07063025 (Georgia) | Primary |
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