| Asikari Perfect Impact, Llc. | |
|
235 Peachtree St Ne Ste 400 Atlanta GA 30303-1400 | |
| (678) 270-6712 | |
| Not Available |
| Full Name | Asikari Perfect Impact, Llc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 235 Peachtree St Ne Ste 400, Atlanta, Georgia |
| Authorized Official Name and Position | Johanna Elizabeth Harris (OWNER/THERAPIST) |
| Authorized Official Contact | 6782706712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Asikari Perfect Impact, Llc. 5472 Shirewick Ln Lithonia GA 30058-3872 Ph: (678) 270-6712 | Asikari Perfect Impact, Llc. 235 Peachtree St Ne Ste 400 Atlanta GA 30303-1400 Ph: (678) 270-6712 |
| NPI Number | 1457981763 |
|---|---|
| Provider Enumeration Date | 01/26/2020 |
| Last Update Date | 01/26/2020 |
| Certification Date | 01/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457981763 | NPI | - | NPPES |
| 1992139505 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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