1750623658 NPI number — THE GEORGE CENTER FOUNDATION

Table of content: (NPI 1750623658)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750623658 NPI number — THE GEORGE CENTER FOUNDATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE GEORGE CENTER FOUNDATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750623658
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 ROSWELL GREEN LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSWELL
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30075
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-464-0913
Provider Business Mailing Address Fax Number:
678-461-8530

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1206 ETRIS RD.
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
ROSWELL
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-998-9599
Provider Business Practice Location Address Fax Number:
678-461-8530
Provider Enumeration Date:
03/19/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RHINEHART
Authorized Official First Name:
HANNAH
Authorized Official Middle Name:
C
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
678-464-0913

Provider Taxonomy Codes

  • Taxonomy code: 225A00000X , with the licence number:  08393 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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