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General NPI Number Information
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NPI Number | 1831621887
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Entity Type | Organization
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Legal Business Name | ALLEN FAMILY HEALTHCARE LLC
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 7930 HIGHWAY 85 STE B
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City | RIVERDALE
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State | GA
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Zip | 30274-3902
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Country | US
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Telephone | 404-827-8971
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Fax | 470-278-5252
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Provider Business Mailing Address
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Address Line | 7930 HIGHWAY 85 STE B
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City | RIVERDALE
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State | GA
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Zip | 30274-3902
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Country | US
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Telephone | 404-827-8971
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Fax | 470-236-0451
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERRIE H ALLEN
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Credential | FNP-C, PMHNP-BC
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Telephone | 678-768-7541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F0712070
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2016009761
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License Number State | GA
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