Provider Demographics
NPI:1639861651
Name:GEORGIA CENTER OF THE DEAF AND HARD OF HEARING, INC.
Entity Type:Organization
Organization Name:GEORGIA CENTER OF THE DEAF AND HARD OF HEARING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-292-5312
Mailing Address - Street 1:2296 HENDERSON MILL RD NE STE 115
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2739
Mailing Address - Country:US
Mailing Address - Phone:404-292-5312
Mailing Address - Fax:
Practice Address - Street 1:2296 HENDERSON MILL RD NE STE 115
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2739
Practice Address - Country:US
Practice Address - Phone:404-292-5312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services