Provider Demographics
NPI:1083901722
Name:COX CARE CONNECTIONS
Entity Type:Organization
Organization Name:COX CARE CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-604-7020
Mailing Address - Street 1:118 NORTH AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-8405
Mailing Address - Country:US
Mailing Address - Phone:678-604-7020
Mailing Address - Fax:404-601-7935
Practice Address - Street 1:118 NORTH AVE
Practice Address - Street 2:SUITE K
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-8405
Practice Address - Country:US
Practice Address - Phone:678-604-7020
Practice Address - Fax:404-601-7935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005841251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA628495412AMedicaid