Provider Demographics
NPI:1407225154
Name:ADDISON MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:ADDISON MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-421-4009
Mailing Address - Street 1:240 CORPORATE CENTER DR STE F
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7214
Mailing Address - Country:US
Mailing Address - Phone:678-565-5544
Mailing Address - Fax:
Practice Address - Street 1:240 CORPORATE CENTER DR STE F
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7214
Practice Address - Country:US
Practice Address - Phone:678-565-5544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health