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General NPI Number Information
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NPI Number | 1184509432
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Entity Type | Organization
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Legal Business Name | AMAZING GRACE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 7910 MALL RING RD
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City | STONECREST
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State | GA
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Zip | 30038
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Country | US
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Telephone | 770-510-6477
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Fax |
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Provider Business Mailing Address
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Address Line | 7910 MALL RING RD STE 200
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City | STONECREST
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State | GA
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Zip | 30038-2698
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Country | US
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Telephone | 770-510-6477
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Fax |
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Authorized Official
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Title or Position | NP
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Name | MS. TOYIN ADEKUNLE
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Credential |
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Telephone | 404-547-5605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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