Provider Demographics
NPI:1801973557
Name:AIDS ALLIANCE OF NORTHWEST GEORGIA, INC.
Entity type:Organization
Organization Name:AIDS ALLIANCE OF NORTHWEST GEORGIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:F
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-606-0953
Mailing Address - Street 1:13 ELIZABETH ST
Mailing Address - Street 2:P. O. BOX 2225
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3117
Mailing Address - Country:US
Mailing Address - Phone:770-606-0953
Mailing Address - Fax:770-606-8462
Practice Address - Street 1:13 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3117
Practice Address - Country:US
Practice Address - Phone:770-606-0953
Practice Address - Fax:770-606-8462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable