| Beacon Wellness Center Llc | |
|
314 Greenville St Lagrange GA 30241-3232 | |
| (706) 881-3441 | |
| Not Available |
| Full Name | Beacon Wellness Center Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 314 Greenville St, Lagrange, Georgia |
| Authorized Official Name and Position | Sujong Chang (OWNER) |
| Authorized Official Contact | 7068813441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Wellness Center Llc 314 Greenville St Lagrange GA 30241-3232 Ph: (706) 881-3441 | Beacon Wellness Center Llc 314 Greenville St Lagrange GA 30241-3232 Ph: (706) 881-3441 |
| NPI Number | 1215782362 |
|---|---|
| Provider Enumeration Date | 04/22/2024 |
| Last Update Date | 06/19/2024 |
| Certification Date | 06/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215782362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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