| Better Self Llc | |
|
8321 Office Park Dr Douglasville GA 30134-6936 | |
| (401) 263-6467 | |
| Not Available |
| Full Name | Better Self Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8321 Office Park Dr, Douglasville, Georgia |
| Authorized Official Name and Position | Ngoneh Bullard (OWNER) |
| Authorized Official Contact | 4012636467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Better Self Llc 6268 Oakdale Rd Se Mableton GA 30126-2836 Ph: (401) 263-6467 | Better Self Llc 8321 Office Park Dr Douglasville GA 30134-6936 Ph: (401) 263-6467 |
| NPI Number | 1730667056 |
|---|---|
| Provider Enumeration Date | 07/30/2018 |
| Last Update Date | 01/17/2023 |
| Certification Date | 01/17/2023 |
| Medicare PECOS PAC ID | 5092063479 |
|---|---|
| Medicare Enrollment ID | O20180801000670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730667056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | CSW005935 (Georgia) | Primary |
| Provider Name | Reginald Drumgoole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689743270 PECOS PAC ID: 7113954447 Enrollment ID: I20050719000594 |
| Provider Name | Crestre M Boddy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598113276 PECOS PAC ID: 1052669678 Enrollment ID: I20180730002018 |
| Provider Name | Ngoneh Bullard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104216373 PECOS PAC ID: 5890043277 Enrollment ID: I20180801000843 |
| Provider Name | Cynthia B Mcneill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891294633 PECOS PAC ID: 9931528965 Enrollment ID: I20200924002047 |
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