Provider Demographics
NPI:1861846487
Name:C&A BEHAVIORAL HEALTH CARE
Entity Type:Organization
Organization Name:C&A BEHAVIORAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIORGADZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-701-7725
Mailing Address - Street 1:4015 S COBB DR SE STE 120
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4015 S COBB DR SE STE 120
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6315
Practice Address - Country:US
Practice Address - Phone:678-701-7725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053532261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health