| Gaps | |
|
101 Hodgins Trl Canton GA 30114-6850 | |
| (706) 768-6695 | |
| (770) 415-1301 |
| Full Name | Gaps |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 101 Hodgins Trl, Canton, Georgia |
| Authorized Official Name and Position | Lawrence Alexander Whitmire (DIRECTOR) |
| Authorized Official Contact | 7067686695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaps 101 Hodgins Trl Canton GA 30114-6850 Ph: (706) 768-6695 | Gaps 101 Hodgins Trl Canton GA 30114-6850 Ph: (706) 768-6695 |
| NPI Number | 1578975652 |
|---|---|
| Provider Enumeration Date | 05/23/2014 |
| Last Update Date | 05/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578975652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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