| Georgia Mentor | |
|
18 Executive Park Dr Ne Suite 1823 Atlanta GA 30329-2206 | |
| (404) 728-1567 | |
| (404) 982-9877 |
| Full Name | Georgia Mentor |
|---|---|
| Speciality | Social Worker |
| Location | 18 Executive Park Dr Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Brett Ian Cohen (COO) |
| Authorized Official Contact | 8003885150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Mentor 18 Executive Park Dr Ne Suite 1823 Atlanta GA 30329-2206 Ph: (404) 728-1567 | Georgia Mentor 18 Executive Park Dr Ne Suite 1823 Atlanta GA 30329-2206 Ph: (404) 728-1567 |
| NPI Number | 1396823340 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 03/12/2023 |
| Certification Date | 03/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396823340 | NPI | - | NPPES |
| 000498847N | Medicaid | GA | |
| 000498847X | Medicaid | GA | |
| 000498847U | Medicaid | GA | |
| 000498847Y | Medicaid | GA | |
| 000498847A | Medicaid | GA | |
| 000498847Q | Medicaid | GA | |
| 000498847AA | Medicaid | GA | |
| 000498847K | Medicaid | GA | |
| 000498847AB | Medicaid | GA | |
| 000498847I | Medicaid | GA | |
| 000498847Z | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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