| Heart Tree Llc | |
|
315 W Ponce De Leon Ave Ste 480 Decatur GA 30030-2489 | |
| (404) 375-4448 | |
| Not Available |
| Full Name | Heart Tree Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 315 W Ponce De Leon Ave Ste 480, Decatur, Georgia |
| Authorized Official Name and Position | Jannah S Goodell (OWNER) |
| Authorized Official Contact | 4043754448 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Tree Llc 300 Colonial Center Pkwy Ste 100n Roswell GA 30076-4892 Ph: (404) 375-4448 | Heart Tree Llc 315 W Ponce De Leon Ave Ste 480 Decatur GA 30030-2489 Ph: (404) 375-4448 |
| NPI Number | 1033683495 |
|---|---|
| Provider Enumeration Date | 01/17/2019 |
| Last Update Date | 01/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033683495 | NPI | - | NPPES |
| CSW4122 | Other | GA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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