| Her Village Founadation Llc | |
|
8341 Grady St Douglasville GA 30134-6910 | |
| (718) 570-3446 | |
| Not Available |
| Full Name | Her Village Founadation Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8341 Grady St, Douglasville, Georgia |
| Authorized Official Name and Position | Shane Janelle Gill (OWNER) |
| Authorized Official Contact | 7185703446 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Her Village Founadation Llc 8341 Grady St Douglasville GA 30134-6910 Ph: () - | Her Village Founadation Llc 8341 Grady St Douglasville GA 30134-6910 Ph: (718) 570-3446 |
| NPI Number | 1285287086 |
|---|---|
| Provider Enumeration Date | 07/20/2019 |
| Last Update Date | 07/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285287086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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