Brilliance Revealed Mental Health, INC.
Community/Behavioral Health in Mcdonough, GA. Organization (NPI-2).
NPI number1861987828
StatusActive
Last updated in NPPESJun 11, 2019
Details
- NPI
- 1861987828
- Entity type
- Organization (NPI-2)
- Legal business name
- Brilliance Revealed Mental Health, INC.
- Organization subpart
- No
- Enumeration date
- Jun 22, 2018
- Last updated
- Jun 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | LPC09991 | GA | Yes |
Practice location
1700 Pennsylvania AveMcdonough, GA 30253-9115
Phone 648-507-0900 · Fax 678-507-0901
Mailing address
2336 Hackamore DrCollege Park, GA 30349-4383
Phone 678-507-0900 · Fax 678-507-0901
Authorized official
Eugenia Lartey-Attigah
Owner
6785070900
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