| Supportive Care Aba Ga Llc | |
|
15 Perry St Ste 404 Newnan GA 30263-1918 | |
| (317) 936-1240 | |
| (317) 936-1241 |
| Full Name | Supportive Care Aba Ga Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 15 Perry St Ste 404, Newnan, Georgia |
| Authorized Official Name and Position | Ruben Kesherim (MEMBER) |
| Authorized Official Contact | 3179361240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Care Aba Ga Llc 15 Perry St Ste 404 Newnan GA 30263-1918 Ph: (317) 936-1240 | Supportive Care Aba Ga Llc 15 Perry St Ste 404 Newnan GA 30263-1918 Ph: (317) 936-1240 |
| NPI Number | 1023731320 |
|---|---|
| Provider Enumeration Date | 09/21/2022 |
| Last Update Date | 09/21/2022 |
| Certification Date | 09/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023731320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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