Healthcare Provider Details

I. General information

NPI: 1174319149
Provider Name (Legal Business Name): NEUROHARMONY AUTISM SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/24/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4027 JORDAN BLVD
COVINGTON GA
30016
US

IV. Provider business mailing address

2274 SALEM RD SE STE 106
CONYERS GA
30013-2295
US

V. Phone/Fax

Practice location:
  • Phone: 770-202-0441
  • Fax:
Mailing address:
  • Phone: 770-202-0441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEYERRA ADAMS
Title or Position: CO OWNER
Credential:
Phone: 470-473-8257