| Bonhomie, L.l.c. | |
|
2375 Wall St Se Ste Office34 Conyers GA 30013-6702 | |
| (404) 402-0650 | |
| (404) 341-9834 |
| Full Name | Bonhomie, L.l.c. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2375 Wall St Se Ste Office34, Conyers, Georgia |
| Authorized Official Name and Position | Corletha L. Norman-bey (OWNER) |
| Authorized Official Contact | 4044020650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonhomie, L.l.c. 1705 Highway 138 Se Unit 83365 Conyers GA 30013-0162 Ph: (404) 402-0650 | Bonhomie, L.l.c. 2375 Wall St Se Ste Office34 Conyers GA 30013-6702 Ph: (404) 402-0650 |
| NPI Number | 1891230421 |
|---|---|
| Provider Enumeration Date | 01/06/2017 |
| Last Update Date | 01/15/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891230421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CSW005255 (Georgia) | Primary |
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