| Intergenerational Resource Center, Inc. | |
|
444 Edgewood Ave Se Atlanta GA 30312-1838 | |
| (404) 524-1023 | |
| (404) 577-1025 |
| Full Name | Intergenerational Resource Center, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 444 Edgewood Ave Se, Atlanta, Georgia |
| Authorized Official Name and Position | Brenda Evelyn Sanford (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4045241023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intergenerational Resource Center, Inc. 444 Edgewood Avenue, S.e. Atlanta GA 30312-1838 Ph: (404) 524-1023 | Intergenerational Resource Center, Inc. 444 Edgewood Ave Se Atlanta GA 30312-1838 Ph: (404) 524-1023 |
| NPI Number | 1962616912 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 09/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962616912 | NPI | - | NPPES |
| 000120117A | Medicaid | GA | |
| 000438105C | Medicaid | GA | |
| 000438105A | Medicaid | GA | |
| 000438105B | Medicaid | GA | |
| 000438105D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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