| Greenleaf Family Centers Inc. | |
|
4775 Jimmy Carter Blvd Ste 300 Norcross GA 30093-3760 | |
| (678) 894-0288 | |
| Not Available |
| Full Name | Greenleaf Family Centers Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4775 Jimmy Carter Blvd Ste 300, Norcross, Georgia |
| Authorized Official Name and Position | Tonica Angel Logan (CEO) |
| Authorized Official Contact | 3363179633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenleaf Family Centers Inc. 4775 Jimmy Carter Blvd Ste 300 Norcross GA 30093-3760 Ph: (678) 894-0288 | Greenleaf Family Centers Inc. 4775 Jimmy Carter Blvd Ste 300 Norcross GA 30093-3760 Ph: (678) 894-0288 |
| NPI Number | 1821758293 |
|---|---|
| Provider Enumeration Date | 12/27/2021 |
| Last Update Date | 06/27/2024 |
| Medicare PECOS PAC ID | 7618322033 |
|---|---|
| Medicare Enrollment ID | O20231004003225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821758293 | NPI | - | NPPES |
| Provider Name | Dominic I Asika |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992749113 PECOS PAC ID: 2769464825 Enrollment ID: I20040602001328 |
| Provider Name | Taheerah D Demby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306962436 PECOS PAC ID: 3577707710 Enrollment ID: I20141024001316 |
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