Provider Demographics
NPI:1669649893
Name:MULTI-CARE HOLISITC HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:MULTI-CARE HOLISITC HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-922-2556
Mailing Address - Street 1:1809 HONEY CREEK COMMONS SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-5830
Mailing Address - Country:US
Mailing Address - Phone:770-922-2556
Mailing Address - Fax:770-922-2485
Practice Address - Street 1:1809 HONEY CREEK COMMONS SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-5830
Practice Address - Country:US
Practice Address - Phone:770-922-2556
Practice Address - Fax:770-922-2485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62004111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty