Provider First Line Business Practice Location Address:
200 CRESCENT CENTRE PARK
Provider Second Line Business Practice Location Address:
DEPARTMENT OF BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
TUCKER
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30084
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-496-3609
Provider Business Practice Location Address Fax Number:
770-496-3708
Provider Enumeration Date:
09/01/2006