By Grace Counseling LLC
Clinic/Center, Adult Mental Health in Roswell, GA. Organization (NPI-2).
NPI number1841808060
StatusActive
Last updated in NPPESJul 14, 2020
Details
- NPI
- 1841808060
- Entity type
- Organization (NPI-2)
- Legal business name
- By Grace Counseling LLC
- Organization subpart
- No
- Enumeration date
- Jul 14, 2020
- Certification date
- Jul 14, 2020
- Last updated
- Jul 14, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
Practice location
100 Hemingway LnRoswell, GA 30075-7024
Phone 470-765-8393
Mailing address
734 Hemingway LnRoswell, GA 30075-7006
Authorized official
Tisa Macklin-Stanley
Provider
4048278038
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