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11030 Jones Bridge Rd Ste 300 Alpharetta GA 30022-4560 | |
| (470) 664-4357 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 11030 Jones Bridge Rd Ste 300, Alpharetta, Georgia |
| Authorized Official Name and Position | Todd Wilson (CEO) |
| Authorized Official Contact | 4045135640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11030 Jones Bridge Rd Ste 300 Alpharetta GA 30022-4560 Ph: (470) 664-4357 | 11030 Jones Bridge Rd Ste 300 Alpharetta GA 30022-4560 Ph: (470) 664-4357 |
| NPI Number | 1679275846 |
|---|---|
| Provider Enumeration Date | 03/20/2023 |
| Last Update Date | 11/06/2023 |
| Certification Date | 11/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679275846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
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