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General NPI Number Information
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NPI Number | 1043030208
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Entity Type | Organization
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Legal Business Name | VIBERT PSYCHIATRIC SOLUTIONS, LLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 1080 EAGLES LANDING PKWY
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-5012
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Country | US
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Telephone | 470-516-9950
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Fax | 470-221-1821
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Provider Business Mailing Address
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Address Line | 108 LUCILLE LN
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City | MCDONOUGH
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State | GA
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Zip | 30252-4969
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Country | US
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Telephone | 470-516-9950
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Fax | 470-221-1821
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Authorized Official
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Title or Position | CEO
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Name | IESHA VIBERT
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Credential | PMHNP
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Telephone | 470-516-9950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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