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Jack W Miller
Adult Mental Health Clinic/Center in Carrollton, Georgia
NPI 1982708368

Jack W Miller is an Adult Mental Health Clinic/Center based in Carrollton, GA and is specialized in Adult Mental Health. Jack W Miller practices in Carrollton, GA. The NPI Number for Jack W Miller is 1982708368 and holds a License No. 044541 (Georgia).

The current practice location address for Jack W Miller is 100 Professional Pl, Carrollton, GA and can be reached out via phone at 770-830-7039 and via fax at 770-830-7149.

Location: 100 Professional Pl, Carrollton, GA, 30117-3874
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1982708368
Provider Name
Jack W Miller
Credential
Provider Entity Type
Organization
Address
100 Professional Pl, Carrollton, GA, 30117-3874
Phone Number
770-830-7039
Fax Number
770-830-7149
Provider Enumeration Date
09/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000767709C 05 GA
institution
Provider Business Practice Location Address Details
Address
100 Professional Pl
City
Carrollton
State
Georgia
Zip
30117-3874
Phone Number
770-830-7039
Fax Number
770-830-7149
person
Provider Business Mailing Address Details
Address
100 Professional Pl
City
Carrollton
State
Georgia
Zip
30117-3874
Phone Number
770-830-7039
Fax Number
770-830-7149
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
044541 (Georgia)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
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