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Southside Medical Center, Inc.
Federally Qualified Health Center (FQHC) in Atlanta, Georgia
NPI 1174641658

Southside Medical Center, Inc. is a Federally Qualified Health Center (FQHC) based in Atlanta, GA and is specialized in Federally Qualified Health Center (FQHC). Southside Medical Center, Inc. practices in Atlanta, GA. The NPI Number for Southside Medical Center, Inc. is 1174641658 and holds a License No. (Georgia).

The current practice location address for Southside Medical Center, Inc. is 1100 Cleveland Ave, Atlanta, GA and can be reached out via phone at 404-627-1385 and via fax at 404-564-0377.

Location: 1100 Cleveland Ave, Atlanta, GA, 30315-1640
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1174641658
Provider Name
Southside Medical Center, Inc.
Credential
Provider Entity Type
Organization
Address
1100 Cleveland Ave, Atlanta, GA, 30315-1640
Phone Number
404-627-1385
Fax Number
404-564-0377
Provider Enumeration Date
03/26/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GRP375 01 GA MEDICARE GROUP
000041764B 05 GA
000444056H 05 GA
04092 01 GA BCBS
institution
Provider Business Practice Location Address Details
Address
1100 Cleveland Ave
City
Atlanta
State
Georgia
Zip
30344-3602
Phone Number
404-627-1385
Fax Number
404-564-0377
person
Provider Business Mailing Address Details
Address
1100 Cleveland Ave
City
Atlanta
State
Georgia
Zip
30344-3602
Phone Number
404-627-1385
Fax Number
404-564-0377
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
()
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
261QF0400X
License No.
(Georgia)
Definition
Definition to come...
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