Provider Demographics
NPI:1285727396
Name:THE FAMILY HEALTH CENTERS OF GEORGIA, INC
Entity type:Organization
Organization Name:THE FAMILY HEALTH CENTERS OF GEORGIA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-752-1400
Mailing Address - Street 1:805 CAMPBELL HILL ST NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1144
Mailing Address - Country:US
Mailing Address - Phone:770-919-0025
Mailing Address - Fax:678-388-1370
Practice Address - Street 1:805 CAMPBELL HILL ST NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1144
Practice Address - Country:US
Practice Address - Phone:770-919-0025
Practice Address - Fax:678-569-0228
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE FAMILY HEALTH CENTERS OF GEORGIA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000437478JMedicaid
GA000437478JMedicaid