Provider Demographics
NPI:1801124029
Name:THE GEORGIA CENTER FOR YOUTH AND FAMILIES, INC.
Entity type:Organization
Organization Name:THE GEORGIA CENTER FOR YOUTH AND FAMILIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-325-7936
Mailing Address - Street 1:11137 TARA BLVD
Mailing Address - Street 2:SUITE 230-154
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-1672
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11137 TARA BLVD
Practice Address - Street 2:SUITE 230-154
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-1672
Practice Address - Country:US
Practice Address - Phone:678-325-7936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management