Organization · NPI-2

Awaken,inspire,restore LLC

Family Medicine · Newnan, GA

NPI number1235929613
StatusActive
Last updated in NPPESMay 29, 2025

Details

NPI
1235929613
Entity type
Organization (NPI-2)
Legal business name
Awaken,inspire,restore LLC
Organization subpart
No
Enumeration date
May 9, 2025
Certification date
May 29, 2025
Last updated
May 29, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

1111 Highway 34 E
Newnan, GA 30265-2182

Phone 770-809-1100

Mailing address

140 Astral Ct
Fayetteville, GA 30214-2595

Phone 904-803-2445

Authorized official

Tashinea Bernadin
Owner
9048032445

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