Healthcare Provider Details

I. General information

NPI: 1316853336
Provider Name (Legal Business Name): EMB3 BEHAVIORAL HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 CLAIREMONT AVE STE 200
DECATUR GA
30030-2546
US

IV. Provider business mailing address

4047 HAVERHILL DR NE
ATLANTA GA
30342-3815
US

V. Phone/Fax

Practice location:
  • Phone: 404-433-5406
  • Fax:
Mailing address:
  • Phone: 404-433-5406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: QUINCY PRESTON-CLARK
Title or Position: CEO/OWNER
Credential:
Phone: 404-433-5406