| The Potter's House Family And Children Treatment Center | |
|
2300 W. Park Place Blvd. Ste. 128, 135, 138 Stone Mountain GA 30087-3561 | |
| (678) 330-4000 | |
| Not Available |
| Full Name | The Potter's House Family And Children Treatment Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2300 W. Park Place Blvd., Stone Mountain, Georgia |
| Authorized Official Name and Position | Elliott Richelson (PRESIDENT, SECRETARY, TREASURER) |
| Authorized Official Contact | 4042475971 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Potter's House Family And Children Treatment Center 242 S. Washington Blvd. Pmb#177 Sarasota FL 34236-6943 Ph: (678) 330-1400 | The Potter's House Family And Children Treatment Center 2300 W. Park Place Blvd. Ste. 128, 135, 138 Stone Mountain GA 30087-3561 Ph: (678) 330-4000 |
| NPI Number | 1326230020 |
|---|---|
| Provider Enumeration Date | 08/16/2007 |
| Last Update Date | 09/09/2022 |
| Certification Date | 09/09/2022 |
| Medicare PECOS PAC ID | 9739319716 |
|---|---|
| Medicare Enrollment ID | O20140313001861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326230020 | NPI | - | NPPES |
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