| Health Rejuvenations Consultant, Inc. | |
|
194 Jonesboro Rd Suite A-6 Jonesboro GA 30236-4812 | |
| (404) 731-6107 | |
| (404) 366-9947 |
| Full Name | Health Rejuvenations Consultant, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 194 Jonesboro Rd, Jonesboro, Georgia |
| Authorized Official Name and Position | Doris D'nin Patillo (CEO-PSYCHOLOGIST) |
| Authorized Official Contact | 4047316107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Rejuvenations Consultant, Inc. 4588 Bouldercrest Rd Ellenwood GA 30294-3613 Ph: (404) 731-6107 | Health Rejuvenations Consultant, Inc. 194 Jonesboro Rd Suite A-6 Jonesboro GA 30236-4812 Ph: (404) 731-6107 |
| NPI Number | 1396868824 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 06/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396868824 | NPI | - | NPPES |
| 01068080 | Other | GA | AMERIGROUP CORPORATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1594 (Georgia) | Secondary |
| 251S00000X | Community/behavioral Health | 004196 (Georgia) | Primary |
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