| NPI | 1134168016 |
|---|---|
| Doing Business As | NORTHSIDE GWINNETT JOAN GLANCY |
| Entity Type | Organization |
| Authorized Contact | JORGE HERNANDEZ VP Amin, Cco 404-851-6378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit (Licence: GA 067-628) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-12-12 |