Provider First Line Business Practice Location Address:
310 BLACK BEAR RIDGE
Provider Second Line Business Practice Location Address:
BLACK BEAR TREATMENT CENTER
Provider Business Practice Location Address City Name:
SAUTEE NACOOCHEE
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:
706-200-4021
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/16/2006