| Imani House Llc | |
|
1227 Augusta West Pkwy Ste 8 Augusta GA 30909-6671 | |
| (706) 825-9051 | |
| (706) 860-1850 |
| Full Name | Imani House Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1227 Augusta West Pkwy Ste 8, Augusta, Georgia |
| Authorized Official Name and Position | Deborah Marie Wilson (PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7068258472 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imani House Llc 1227 Augusta West Pkwy Ste 8 Augusta GA 30909-6671 Ph: (706) 825-9051 | Imani House Llc 1227 Augusta West Pkwy Ste 8 Augusta GA 30909-6671 Ph: (706) 825-9051 |
| NPI Number | 1487888566 |
|---|---|
| Provider Enumeration Date | 05/05/2009 |
| Last Update Date | 05/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487888566 | NPI | - | NPPES |
| 172613501 | Medicaid | TX | |
| 184952006A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC004458 (Georgia) | Primary |
| 251S00000X | Community/behavioral Health | 18226 (Texas) | Secondary |
Breakthrough Counseling, Coaching And Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2903 Galahad Way, Augusta, GA 30909 Phone: 404-496-4614 Fax: 866-923-0754 | |
Samantha L Amses Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Pleasant Home Rd Ste G1, Augusta, GA 30907 Phone: 908-433-4484 Fax: 706-364-4589 | |
Perez Counseling And Consulting Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1051 Sims Dr, Augusta, GA 30909 Phone: 706-589-0914 | |
Living-in-care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 716 5th St, Augusta, GA 30901 Phone: 912-605-6167 | |