| Asili Wellness | |
|
4325 1st Ave # 1461 Tucker GA 30084-4498 | |
| (678) 404-1077 | |
| Not Available |
| Full Name | Asili Wellness |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4325 1st Ave # 1461, Tucker, Georgia |
| Authorized Official Name and Position | Nicole Ware Spencer (OWNER) |
| Authorized Official Contact | 6784041077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Asili Wellness Po Box 1461 Tucker GA 30085-1461 Ph: (678) 404-1077 | Asili Wellness 4325 1st Ave # 1461 Tucker GA 30084-4498 Ph: (678) 404-1077 |
| NPI Number | 1326683517 |
|---|---|
| Provider Enumeration Date | 11/12/2019 |
| Last Update Date | 12/20/2021 |
| Certification Date | 12/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326683517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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