| Resiliency Behavioral Health Services Llc | |
|
145 Govenors Square Ste A Fayetteville GA 30269 | |
| (770) 668-3130 | |
| (267) 295-2834 |
| Full Name | Resiliency Behavioral Health Services Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 145 Govenors Square, Fayetteville, Georgia |
| Authorized Official Name and Position | Charles Joseph Popov (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7706683130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Resiliency Behavioral Health Services Llc Po Box 302 Turin GA 30289-0302 Ph: (770) 668-3130 | Resiliency Behavioral Health Services Llc 145 Govenors Square Ste A Fayetteville GA 30269 Ph: (770) 668-3130 |
| NPI Number | 1689139362 |
|---|---|
| Provider Enumeration Date | 02/06/2019 |
| Last Update Date | 02/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689139362 | NPI | - | NPPES |
| 003104588 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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