Provider Demographics
NPI:1508228370
Name:CORRECTHEALTH GDC, LLC
Entity Type:Organization
Organization Name:CORRECTHEALTH GDC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUSSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-692-4750
Mailing Address - Street 1:3384 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1181
Mailing Address - Country:US
Mailing Address - Phone:770-692-4750
Mailing Address - Fax:770-692-9379
Practice Address - Street 1:1 BOSTICK CIR
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31062-7526
Practice Address - Country:US
Practice Address - Phone:770-608-9315
Practice Address - Fax:770-692-9379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility