Loganville Community Ministry Village, Inc.
NPI #1124253679 in Loganville, Georgia
Provider Information
- NPI Number
- 1124253679
- Entity Type
- Organization
- Organization Name
- Loganville Community Ministry Village, Inc.
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- May 27, 2009
- Last Updated
- May 27, 2009
Practice Location
- Address
- 678 TOM BREWER RD
- City
- Loganville
- State
- Georgia
- ZIP Code
- 30052-4005
- Phone
- (770) 554-3599
Authorized Official
- Name
- MR. CHET ALLEN FOWLER, LPC
- Title
- EXECUTIVE DIRECTOR
- Phone
- (770) 554-3599
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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