Georgia Mountains Community Services

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Toccoa, GA

NPI 1245541192 · NPPES record last updated Jun 25, 2010

Key facts

NPI
1245541192
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
GEORGIA MOUNTAINS COMMUNITY SERVICES
Practice address
5700 Fernside Dr
Toccoa, GA 30577-8942
Phone
(706) 886-6521
Fax
(678) 513-5836
NPI assigned
Jun 25, 2010
Organization subpart
No

Authorized official

Name
Karen R Tucker
Title
Billing Manager
Phone
(678) 513-5733

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Georgia Mountain Community SVS (127 organizations share this tax ID)

Locations

64 Boulevard
Toccoa, GA 30577

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

5700 Fernside Dr
Toccoa, GA 30577-8942

Mailing address

4331 Thurmon Tanner Rd
Flowery Branch, GA 30542-2829
Phone (678) 513-5733

Other identifiers

IdentifierTypeStateIssuer
000666553EMedicaidGA

Other names

  • Avita Community Partners Doing business as

Other providers in Toccoa, GA

All providers in Toccoa, GA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

Sources for this page

Verify at the official NPI Registry.