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4720 Peachtree Industrial Blvd Ste 4201 Berkley Lake GA 30071 | |
(404) 900-9586 | |
Not Available |
Full Name | |
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Speciality | Counselor - Professional |
Location | 4720 Peachtree Industrial Blvd, Berkley Lake, Georgia |
Authorized Official Name and Position | Bertrina Olivia West (CLINICAL DIRECTOR) |
Authorized Official Contact | 4049009583 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3470 Mcclure Bridge Rd Ste 621 Duluth GA 30096 Ph: (404) 900-9586 | 4720 Peachtree Industrial Blvd Ste 4201 Berkley Lake GA 30071 Ph: (404) 900-9586 |
NPI Number | 1659934255 |
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Provider Enumeration Date | 04/18/2019 |
Last Update Date | 08/05/2024 |
Identifier | Type | State | Issuer |
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1659934255 | NPI | - | NPPES |
003299810A | Medicaid | GA |