Alan  M  Harben    MD
Contract Details
Restore Neurobehavioral Center
Facility name
Provider ID
P000002654
NPI
1669652095
Tax ID
582287958
Effective Date
12/15/2010
Last Updated
2/22/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_474
Location Details
Address
11775 Pointe Place, Suite 103
Roswell, GA 30076
United States
County
Fulton
Phone
7706190010 (Phone)
Billing Details
Address
11775 Pointe Place, Suite 103
Atlanta, GA 30076
Billing Phone
7705638248
Specialty Type
Pain Management
Map
Address