| Destination Greatness-georgia, Llc | |
|
3343 Peachtree Rd Ne Ste 145-1058 Atlanta GA 30326-1085 | |
| (800) 647-3345 | |
| (866) 923-0754 |
| Full Name | Destination Greatness-georgia, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3343 Peachtree Rd Ne Ste 145-1058, Atlanta, Georgia |
| Authorized Official Name and Position | Shanna Amanda Jefferson (CEO) |
| Authorized Official Contact | 8006473345 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Destination Greatness-georgia, Llc Po Box 29144 Atlanta GA 30359-0144 Ph: () - | Destination Greatness-georgia, Llc 3343 Peachtree Rd Ne Ste 145-1058 Atlanta GA 30326-1085 Ph: (800) 647-3345 |
| NPI Number | 1225582562 |
|---|---|
| Provider Enumeration Date | 08/03/2016 |
| Last Update Date | 02/10/2021 |
| Certification Date | 02/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225582562 | NPI | - | NPPES |
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