| House Of Preparation, Llc | |
|
110 Eagle Spring Dr Suite D Stockbridge GA 30281-6488 | |
| (866) 945-9685 | |
| (866) 945-9685 |
| Full Name | House Of Preparation, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 110 Eagle Spring Dr, Stockbridge, Georgia |
| Authorized Official Name and Position | Casandra Jones (BUSINESS MANAGER) |
| Authorized Official Contact | 8669459685 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| House Of Preparation, Llc Po Box 321 Mcdonough GA 30253-0321 Ph: (866) 945-9685 | House Of Preparation, Llc 110 Eagle Spring Dr Suite D Stockbridge GA 30281-6488 Ph: (866) 945-9685 |
| NPI Number | 1356671531 |
|---|---|
| Provider Enumeration Date | 01/11/2010 |
| Last Update Date | 02/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356671531 | NPI | - | NPPES |
| 858969128A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 441931037035 (Georgia) | Primary |
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