| Gentle Care Behavioral Health Pllc | |
|
320 Lanier Ave W Ste 200 Fayetteville GA 30214 | |
| (404) 999-4726 | |
| Not Available |
| Full Name | Gentle Care Behavioral Health Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 320 Lanier Ave W, Fayetteville, Georgia |
| Authorized Official Name and Position | Latoyia Jackson (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 4049994726 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gentle Care Behavioral Health Pllc 320 Lanier Ave W Ste 200 Fayetteville GA 30214-7443 Ph: (404) 999-4726 | Gentle Care Behavioral Health Pllc 320 Lanier Ave W Ste 200 Fayetteville GA 30214 Ph: (404) 999-4726 |
| NPI Number | 1407510878 |
|---|---|
| Provider Enumeration Date | 10/22/2021 |
| Last Update Date | 11/12/2021 |
| Certification Date | 10/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407510878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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