Mimi McDonald LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Woodstock, GA. Organization (NPI-2).
NPI number1104437987
StatusActive
Last updated in NPPESJun 9, 2022
Details
- NPI
- 1104437987
- Entity type
- Organization (NPI-2)
- Legal business name
- Mimi McDonald LLC
- Organization subpart
- No
- Enumeration date
- Aug 13, 2020
- Certification date
- Nov 19, 2020
- Last updated
- Jun 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Other names
- Haven Counseling Center (Doing Business As)
Practice location
405 Creekstone RdgWoodstock, GA 30188-3746
Phone 470-798-0202 · Fax 470-410-7602
Mailing address
405 Creekstone RdgWoodstock, GA 30188-3746
Phone 470-798-0202 · Fax 470-410-7602
Authorized official
Janet Mimi McDonald
Owner
4707980202
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