| Center For Authentic Life & Relationship, Llc | |
|
1301 Shiloh Rd Nw Ste 530 Kennesaw GA 30144-7153 | |
| (678) 516-6902 | |
| (470) 401-1090 |
| Full Name | Center For Authentic Life & Relationship, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1301 Shiloh Rd Nw Ste 530, Kennesaw, Georgia |
| Authorized Official Name and Position | Roy Alin Blankenship (MANAGING PARTNER) |
| Authorized Official Contact | 6785166902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Authentic Life & Relationship, Llc 1426 Olde Forge Ln Woodstock GA 30189-1553 Ph: (678) 516-6902 | Center For Authentic Life & Relationship, Llc 1301 Shiloh Rd Nw Ste 530 Kennesaw GA 30144-7153 Ph: (678) 516-6902 |
| NPI Number | 1366906778 |
|---|---|
| Provider Enumeration Date | 01/30/2019 |
| Last Update Date | 06/04/2025 |
| Certification Date | 06/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366906778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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