Ideal Minds Behavioral Services | |
2090 Lawrenceville Suwanee Rd # 747 Suwanee GA 30024-2600 | |
(678) 974-0342 | |
Not Available |
Full Name | Ideal Minds Behavioral Services |
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Speciality | Clinic/Center |
Location | 2090 Lawrenceville Suwanee Rd # 747, Suwanee, Georgia |
Authorized Official Name and Position | Mary Opara (CEO/AUTHORIZED OFFICIAL) |
Authorized Official Contact | 6789740342 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ideal Minds Behavioral Services 2090 Lawrenceville Suwanee Rd # 747 Suwanee GA 30024-2600 Ph: (678) 974-0342 | Ideal Minds Behavioral Services 2090 Lawrenceville Suwanee Rd # 747 Suwanee GA 30024-2600 Ph: (678) 974-0342 |
NPI Number | 1144968322 |
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Provider Enumeration Date | 05/26/2022 |
Last Update Date | 05/26/2022 |
Certification Date | 05/26/2022 |
Medicare PECOS PAC ID | 6608256086 |
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Medicare Enrollment ID | O20220630003184 |
Identifier | Type | State | Issuer |
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1144968322 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Mary Opara |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1821494352 PECOS PAC ID: 9931420981 Enrollment ID: I20150603001181 |
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