| Abby Behavioral Health | |
|
2121 Fountain Dr Ste D Snellville GA 30078-2900 | |
| (470) 435-5341 | |
| Not Available |
| Full Name | Abby Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 2121 Fountain Dr Ste D, Snellville, Georgia |
| Authorized Official Name and Position | Olufunmilayo Temitope Ajala (NURSE PRACTITIONER) |
| Authorized Official Contact | 4704355341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abby Behavioral Health 2121 Fountain Dr Ste D Snellville GA 30078-2900 Ph: (470) 435-5341 | Abby Behavioral Health 2121 Fountain Dr Ste D Snellville GA 30078-2900 Ph: (470) 435-5341 |
| NPI Number | 1750061206 |
|---|---|
| Provider Enumeration Date | 07/20/2023 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Medicare PECOS PAC ID | 4880032853 |
|---|---|
| Medicare Enrollment ID | O20240410000730 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750061206 | NPI | - | NPPES |
| Provider Name | Olufunmilayo Temitope Ajala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750033684 PECOS PAC ID: 8628375904 Enrollment ID: I20240410000760 |
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