| Professional Associates Health Care Of Georgia | |
|
310 Ivanhoe Dr Fayetteville GA 30215-2041 | |
| (770) 461-9228 | |
| (770) 461-9228 |
| Full Name | Professional Associates Health Care Of Georgia |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 310 Ivanhoe Dr, Fayetteville, Georgia |
| Authorized Official Name and Position | Agneau Jean-simon (STAFF) |
| Authorized Official Contact | 7708655073 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Associates Health Care Of Georgia 316 S 9th St Griffin GA 30224-4159 Ph: () - | Professional Associates Health Care Of Georgia 310 Ivanhoe Dr Fayetteville GA 30215-2041 Ph: (770) 461-9228 |
| NPI Number | 1225338577 |
|---|---|
| Provider Enumeration Date | 11/02/2010 |
| Last Update Date | 03/14/2024 |
| Certification Date | 03/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225338577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 932102913 (Georgia) | Primary |
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