Provider Demographics
NPI:1902641749
Name:PEACHTREE CHRISTIAN HEALTH, INC.
Entity type:Organization
Organization Name:PEACHTREE CHRISTIAN HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MANCINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-624-2727
Mailing Address - Street 1:3090 PREMIERE PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8915
Mailing Address - Country:US
Mailing Address - Phone:770-624-2727
Mailing Address - Fax:
Practice Address - Street 1:3090 PREMIERE PKWY STE 400
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8915
Practice Address - Country:US
Practice Address - Phone:770-624-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care