| Ga Champion Project Inc | |
|
7651 Tara Blvd Suite 2000 Jonesboro GA 30236-7322 | |
| (770) 210-8484 | |
| Not Available |
| Full Name | Ga Champion Project Inc |
|---|---|
| Speciality | Counselor |
| Location | 7651 Tara Blvd, Jonesboro, Georgia |
| Authorized Official Name and Position | Michael Winfree (PROGRAM ADMINISTRATOR) |
| Authorized Official Contact | 7704131690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ga Champion Project Inc 7651 Tara Blvd Suite 2000 Jonesboro GA 30236-7322 Ph: () - | Ga Champion Project Inc 7651 Tara Blvd Suite 2000 Jonesboro GA 30236-7322 Ph: (770) 210-8484 |
| NPI Number | 1043544968 |
|---|---|
| Provider Enumeration Date | 09/24/2009 |
| Last Update Date | 09/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043544968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 0000000000 (Georgia) | Primary |
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