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1003567223
UN SIMPLE MINDED
LAWRENCEVILLE, GA
NPI
1003567223
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Entity Type
Organization
Authorized Contact
AMIR BERNARD LANE
Owner
678-975-5539
Organization Subpart ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2022-01-11
Last Update Date
2022-01-11
Business Address
UN SIMPLE MINDED
810 EAGLE COVE WAY
LAWRENCEVILLE, GA 30044-5843
Phone number: 678-975-5539
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Mailing Address
UN SIMPLE MINDED
810 EAGLE COVE WAY
LAWRENCEVILLE, GA 30044-5843
Phone number: 678-975-5539
Copy
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