Provider Demographics
NPI:1699216416
Name:ABVA, INC
Entity Type:Organization
Organization Name:ABVA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:BRAND
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-338-1176
Mailing Address - Street 1:4565 ROCKMART RD SE
Mailing Address - Street 2:UNIT 1261
Mailing Address - City:SILVER CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30173-2442
Mailing Address - Country:US
Mailing Address - Phone:706-386-1176
Mailing Address - Fax:
Practice Address - Street 1:4565 ROCKMART RD SE
Practice Address - Street 2:UNIT 1261
Practice Address - City:SILVER CREEK
Practice Address - State:GA
Practice Address - Zip Code:30173-2442
Practice Address - Country:US
Practice Address - Phone:706-386-1176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA676232084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty