| Atl Sport | |
|
5376 Jonesboro Rd Lake City GA 30260 | |
| (404) 748-1102 | |
| Not Available |
| Full Name | Atl Sport |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5376 Jonesboro Rd, Lake City, Georgia |
| Authorized Official Name and Position | Kimberly D Alexander (LICENSE PROFESSIONAL COUSELER) |
| Authorized Official Contact | 4046256262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Atl Sport 5376 Jonesboro Rd Lake City GA 30260-3557 Ph: (404) 748-1102 | Atl Sport 5376 Jonesboro Rd Lake City GA 30260 Ph: (404) 748-1102 |
| NPI Number | 1679067870 |
|---|---|
| Provider Enumeration Date | 06/20/2018 |
| Last Update Date | 06/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679067870 | NPI | - | NPPES |
| 1396092912 | Other | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Cedar Tree Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5588 Reynolds Rd, Lake City, GA 30260 Phone: 706-442-5929 |