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General NPI Number Information
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NPI Number | 1598464661
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Entity Type | Organization
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Legal Business Name | ACME HEALTH NETWORK LLC
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 5579 CHAMBLEE DUNWOODY RD STE B
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City | DUNWOODY
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State | GA
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Zip | 30338-4100
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Country | US
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Telephone | 678-509-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 5579 CHAMBLEE DUNWOODY RD STE B
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City | DUNWOODY
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State | GA
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Zip | 30338-4100
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Country | US
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Telephone | 678-509-6060
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | KRISTINE AIBANGBEE
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Credential |
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Telephone | 470-451-3341
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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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