Provider Demographics
NPI:1235324252
Name:ATLANTA FAMILY PSYCHIATRY, INC
Entity Type:Organization
Organization Name:ATLANTA FAMILY PSYCHIATRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:WARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-806-8323
Mailing Address - Street 1:PO BOX 871149
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-0029
Mailing Address - Country:US
Mailing Address - Phone:770-806-8323
Mailing Address - Fax:
Practice Address - Street 1:6340 SUGARLOAF PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4333
Practice Address - Country:US
Practice Address - Phone:770-806-8323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty