Healthcare Provider Details

I. General information

NPI: 1922933233
Provider Name (Legal Business Name): TAILORED WELLNESS INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 BEECH VALLEY DR SE
SMYRNA GA
30080-2507
US

IV. Provider business mailing address

2231 BEECH VALLEY DR SE
SMYRNA GA
30080-2507
US

V. Phone/Fax

Practice location:
  • Phone: 404-552-8500
  • Fax:
Mailing address:
  • Phone: 404-552-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. BOBBI LEE JONES
Title or Position: OWNER
Credential: LPC, MA, NCC
Phone: 404-585-1910