Provider Demographics
NPI:1801447487
Name:GA NEW CONNECTIONS THERAPEUTIC CENTER, LLC
Entity type:Organization
Organization Name:GA NEW CONNECTIONS THERAPEUTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHEREE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-804-9455
Mailing Address - Street 1:600 PEACHTREE PKWY STE 111
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6899
Mailing Address - Country:US
Mailing Address - Phone:678-804-9455
Mailing Address - Fax:470-239-1102
Practice Address - Street 1:600 PEACHTREE PKWY STE 111
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6899
Practice Address - Country:US
Practice Address - Phone:678-804-9455
Practice Address - Fax:470-239-1102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty