Provider First Line Business Practice Location Address:
310 BLACK BEAR RIDGE RD
Provider Second Line Business Practice Location Address:
BLACK BEAR TREATMENT CENTER
Provider Business Practice Location Address City Name:
SAUTEE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30571
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
470-539-6905
Provider Business Practice Location Address Fax Number:
706-219-3078
Provider Enumeration Date:
10/19/2016