| Operation Street Harvest, Inc. Dba Ga Black Licensed Assoc. Counselors | |
|
1 W Court Sq Ste 750 Decatur GA 30030-2538 | |
| (678) 978-9391 | |
| (770) 538-1716 |
| Full Name | Operation Street Harvest, Inc. Dba Ga Black Licensed Assoc. Counselors |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1 W Court Sq Ste 750, Decatur, Georgia |
| Authorized Official Name and Position | Tonya Lynn Sumner Brown (CEO/CLINICAL SUPERVISOR/PRESIDENT) |
| Authorized Official Contact | 6789789391 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Operation Street Harvest, Inc. Dba Ga Black Licensed Assoc. Counselors 3982 Misty Lk Ellenwood GA 30294-1164 Ph: (678) 978-9391 | Operation Street Harvest, Inc. Dba Ga Black Licensed Assoc. Counselors 1 W Court Sq Ste 750 Decatur GA 30030-2538 Ph: (678) 978-9391 |
| NPI Number | 1972361269 |
|---|---|
| Provider Enumeration Date | 03/11/2024 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972361269 | NPI | - | NPPES |
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