OrganizationActive
Driven From Within
NPI 1831533405 · Health Maintenance Organization · Lawrenceville, GA
Provider details
- NPI number
- 1831533405
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Michah Davenport, Ceo/Founder(678) 755-5580
Specialties & taxonomies
Managed Care Organizations
- Preferred Provider Organization305R00000X
Managed Care Organizations
Practice location
1377 Ivey Pointe Dr
Lawrenceville, GA 30045-2647
Phone: (678) 755-5580
Approximate (ZIP-level) locationGet directions
Mailing address
1377 Ivey Pointe Dr
Lawrenceville, GA 30045-2647
Registry dates
- Enumerated
- 2013-04-25
- Last updated
- 2013-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.