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NPI Code Detail

MEDICARE: ATLANTA TELEHEALTH

MEDICARE: ATLANTA TELEHEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1184216715
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATLANTA TELEHEALTH
Provider Business Mailing Address
First Line : 3941 OLD ATLANTA STATION DR SE
Second Line :
City : ATLANTA
State : GA
Zip : 30339-1984
Country : US
Telephone Number : 678-761-5956
Fax Number :
Provider Business Practice Location Address
First Line : 3941 OLD ATLANTA STATION DR SE
Second Line :
City : ATLANTA
State : GA
Zip : 30339-1984
Country : US
Telephone Number : 678-761-5956
Fax Number :
Authorized Official
Title or Position : OWNER
Name : COURTNEY HARRING
Credential :
Telephone Number : 678-761-5956
Provider Enumeration Date : 02/04/2021
Last Update Date : 03/01/2021

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Directions to “ATLANTA TELEHEALTH ” Practice Location

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