Summitridge Center For Psychiatry And Addiction Medicine | |
250 Scenic Hwy Lawrenceville GA 30045-5675 | |
(678) 442-5622 | |
(770) 339-3459 |
Full Name | Summitridge Center For Psychiatry And Addiction Medicine |
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Speciality | Psychiatric Unit |
Location | 250 Scenic Hwy, Lawrenceville, Georgia |
Authorized Official Name and Position | Thomas Y Mcbride (SR. VP., CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 6784424308 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Summitridge Center For Psychiatry And Addiction Medicine Po Box 1190 Lawrenceville GA 30046-1190 Ph: (678) 442-5622 | Summitridge Center For Psychiatry And Addiction Medicine 250 Scenic Hwy Lawrenceville GA 30045-5675 Ph: (678) 442-5622 |
NPI Number | 1982634572 |
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Provider Enumeration Date | 07/03/2006 |
Last Update Date | 07/26/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982634572 | NPI | - | NPPES |
000294A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
273R00000X | Psychiatric Unit | 067-460 (Georgia) | Primary |
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