| Csu | |
|
132 Stanley Ct Suite F Lawrenceville GA 30046-9061 | |
| (470) 798-0244 | |
| (678) 828-8164 |
| Full Name | Csu |
|---|---|
| Speciality | Counselor - Professional |
| Location | 132 Stanley Ct, Lawrenceville, Georgia |
| Authorized Official Name and Position | Donna Cleveland Rowden (CEO) |
| Authorized Official Contact | 4707980244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Csu 5550 Rose Ridge Ct Flowery Branch GA 30542-5078 Ph: (678) 481-7547 | Csu 132 Stanley Ct Suite F Lawrenceville GA 30046-9061 Ph: (470) 798-0244 |
| NPI Number | 1093187049 |
|---|---|
| Provider Enumeration Date | 10/28/2015 |
| Last Update Date | 01/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093187049 | NPI | - | NPPES |
| 003165202A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC007296 (Georgia) | Primary |
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