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NPI Code Detail

MEDICARE: EMBRACING HOPE LLC

MEDICARE: EMBRACING HOPE LLC
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
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1225690894
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMBRACING HOPE LLC
Provider Business Mailing Address
First Line : PO BOX 1027
Second Line :
City : REX
State : GA
Zip : 30273-8027
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 40 MACON ST STE D
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-3233
Country : US
Telephone Number : 678-831-7377
Fax Number : 678-487-5340
Authorized Official
Title or Position : ORGANIZER
Name : CHARONDA P GARDNER
Credential : LPC
Telephone Number : 404-392-6280
Provider Enumeration Date : 07/03/2019
Last Update Date : 01/27/2021

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Directions to “EMBRACING HOPE LLC ” Practice Location

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