Genesis Alliance For Mental Wellness, Llc | |
4540 Memorial Dr Ste C Decatur GA 30032-1455 | |
(404) 501-0003 | |
(404) 501-0033 |
Full Name | Genesis Alliance For Mental Wellness, Llc |
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Speciality | Community/Behavioral Health |
Location | 4540 Memorial Dr Ste C, Decatur, Georgia |
Authorized Official Name and Position | Temeka Abbott (CEO) |
Authorized Official Contact | 4045010003 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Genesis Alliance For Mental Wellness, Llc 4540 Memorial Dr Ste C Decatur GA 30032-1455 Ph: (404) 501-0003 | Genesis Alliance For Mental Wellness, Llc 4540 Memorial Dr Ste C Decatur GA 30032-1455 Ph: (404) 501-0003 |
NPI Number | 1891816906 |
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Provider Enumeration Date | 04/03/2007 |
Last Update Date | 07/11/2025 |
Certification Date | 07/11/2025 |
Medicare PECOS PAC ID | 8921383944 |
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Medicare Enrollment ID | O20200309001516 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891816906 | NPI | - | NPPES |
042312259A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Adaku Nwakego Njoku - Animashaun |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1164682431 PECOS PAC ID: 7416253919 Enrollment ID: I20181101003026 |
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