Provider Demographics
NPI:1477093839
Name:DM & ADR, INC.
Entity Type:Organization
Organization Name:DM & ADR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCORKLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-552-0688
Mailing Address - Street 1:1710 COMMERCE RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607-1018
Mailing Address - Country:US
Mailing Address - Phone:706-552-0688
Mailing Address - Fax:
Practice Address - Street 1:1710 COMMERCE RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607-1018
Practice Address - Country:US
Practice Address - Phone:706-552-0688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GANTP001005251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health