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General NPI Number Information
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NPI Number | 1225690894
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Entity Type | Organization
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Legal Business Name | EMBRACING HOPE LLC
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Dates
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Enumeration Date | 07/03/2019
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 40 MACON ST STE D
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City | MCDONOUGH
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State | GA
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Zip | 30253-3233
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Country | US
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Telephone | 678-831-7377
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Fax | 678-487-5340
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Provider Business Mailing Address
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Address Line | PO BOX 1027
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City | REX
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State | GA
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Zip | 30273-8027
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORGANIZER
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Name | CHARONDA P GARDNER
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Credential | LPC
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Telephone | 404-392-6280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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