| Eagle Ranch, Inc. | |
|
5500 Union Church Rd Flowery Branch GA 30542-5216 | |
| (770) 967-8500 | |
| Not Available |
| Full Name | Eagle Ranch, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5500 Union Church Rd, Flowery Branch, Georgia |
| Authorized Official Name and Position | Steven Watts (CFO) |
| Authorized Official Contact | 7709678500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Ranch, Inc. Po Box 7200 Chestnut Mountain GA 30502-0050 Ph: (770) 967-8500 | Eagle Ranch, Inc. 5500 Union Church Rd Flowery Branch GA 30542-5216 Ph: (770) 967-8500 |
| NPI Number | 1922744374 |
|---|---|
| Provider Enumeration Date | 05/09/2022 |
| Last Update Date | 05/09/2022 |
| Certification Date | 04/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922744374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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