| Healing Our Village Of Maryland, Inc. | |
|
177 N Main St Jonesboro GA 30236-3567 | |
| (800) 788-0941 | |
| Not Available |
| Full Name | Healing Our Village Of Maryland, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 177 N Main St, Jonesboro, Georgia |
| Authorized Official Name and Position | Lenore Coleman (PRESIDENT) |
| Authorized Official Contact | 7037951983 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Our Village Of Maryland, Inc. 405 Benjamin Cir Fayetteville GA 30214-3346 Ph: () - | Healing Our Village Of Maryland, Inc. 177 N Main St Jonesboro GA 30236-3567 Ph: (800) 788-0941 |
| NPI Number | 1699188367 |
|---|---|
| Provider Enumeration Date | 06/10/2014 |
| Last Update Date | 05/05/2025 |
| Medicare PECOS PAC ID | 0143630012 |
|---|---|
| Medicare Enrollment ID | O20201104000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699188367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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