Provider Demographics
NPI:1942548466
Name:PROFESSIONAL ASSOCIATES HEALTH CARE OF GEORGIA
Entity Type:Organization
Organization Name:PROFESSIONAL ASSOCIATES HEALTH CARE OF GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SONY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-233-8778
Mailing Address - Street 1:316 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4159
Mailing Address - Country:US
Mailing Address - Phone:707-233-8778
Mailing Address - Fax:678-565-8496
Practice Address - Street 1:316 S 9TH ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4159
Practice Address - Country:US
Practice Address - Phone:770-233-8778
Practice Address - Fax:678-565-8496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care