| Brilliance Revealed Mental Health, Inc. | |
|
1700 Pennsylvania Ave Mcdonough GA 30253-9115 | |
| (648) 507-0900 | |
| (678) 507-0901 |
| Full Name | Brilliance Revealed Mental Health, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1700 Pennsylvania Ave, Mcdonough, Georgia |
| Authorized Official Name and Position | Eugenia Lartey-attigah (OWNER) |
| Authorized Official Contact | 6785070900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brilliance Revealed Mental Health, Inc. 2336 Hackamore Dr College Park GA 30349-4383 Ph: (678) 507-0900 | Brilliance Revealed Mental Health, Inc. 1700 Pennsylvania Ave Mcdonough GA 30253-9115 Ph: (648) 507-0900 |
| NPI Number | 1861987828 |
|---|---|
| Provider Enumeration Date | 06/22/2018 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861987828 | NPI | - | NPPES |
| 1710487384 | Other | GA | BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC09991 (Georgia) | Primary |
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