| Hero House Physicians Group Llc | |
|
1318 Shiloh Trail East Nw Kennesaw GA 30144-2044 | |
| (949) 215-5795 | |
| Not Available |
| Full Name | Hero House Physicians Group Llc |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 1318 Shiloh Trail East Nw, Kennesaw, Georgia |
| Authorized Official Name and Position | Randy Haveson (CEO) |
| Authorized Official Contact | 9492155796 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hero House Physicians Group Llc 510 Glengate Cv Sandy Springs GA 30328-7255 Ph: (949) 215-5795 | Hero House Physicians Group Llc 1318 Shiloh Trail East Nw Kennesaw GA 30144-2044 Ph: (949) 215-5795 |
| NPI Number | 1316213101 |
|---|---|
| Provider Enumeration Date | 03/27/2012 |
| Last Update Date | 01/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316213101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
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