| To the Core Healing- LLC | |
|
105 Hickory Ave Fayetteville GA 30215-1801 | |
| (404) 275-2602 | |
| Not Available |
| Full Name | To the Core Healing- LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 105 Hickory Ave, Fayetteville, Georgia |
| Authorized Official Name and Position | Amelia Johns-riley (DIRECTOR) |
| Authorized Official Contact | 4042752602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| To the Core Healing- LLC 105 Hickory Ave Fayetteville GA 30215-1801 | To the Core Healing- LLC 105 Hickory Ave Fayetteville GA 30215-1801 Ph: (404) 275-2602 |
| NPI Number | 1861361693 |
|---|---|
| Provider Enumeration Date | 10/31/2025 |
| Last Update Date | 10/31/2025 |
| Certification Date | 10/30/2025 |
| Medicare PECOS PAC ID | 9638653330 |
|---|---|
| Medicare Enrollment ID | O20260320000573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861361693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
| Provider Name | Amelia Johns-riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699365866 PECOS PAC ID: 3678952348 Enrollment ID: I20220627001890 |
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