Provider Demographics
NPI:1457725152
Name:ATHENS NEIGHBORHOOD HEALTH CENTER INC
Entity Type:Organization
Organization Name:ATHENS NEIGHBORHOOD HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALMENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:762-499-6961
Mailing Address - Street 1:P O BOX 147
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30603
Mailing Address - Country:US
Mailing Address - Phone:762-499-6961
Mailing Address - Fax:706-850-9047
Practice Address - Street 1:3320 OLD JEFFERSON RD
Practice Address - Street 2:BUILDING 300
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607
Practice Address - Country:US
Practice Address - Phone:706-850-9041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATHENS NEIGHBORHOOD HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-18
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA29631261QC1500X
261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health