| Intentional Hearts, Inc. | |
|
4200 Northside Pkwy Nw Bldg 1, Ste 200 Atlanta GA 30327-3054 | |
| (770) 623-3331 | |
| Not Available |
| Full Name | Intentional Hearts, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4200 Northside Pkwy Nw, Atlanta, Georgia |
| Authorized Official Name and Position | Michael Todd Wilson (PRESIDENT) |
| Authorized Official Contact | 7706233331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intentional Hearts, Inc. 4200 Northside Pkwy Nw Bldg 1, Ste 200 Atlanta GA 30327-3054 Ph: (770) 623-3331 | Intentional Hearts, Inc. 4200 Northside Pkwy Nw Bldg 1, Ste 200 Atlanta GA 30327-3054 Ph: (770) 623-3331 |
| NPI Number | 1003056698 |
|---|---|
| Provider Enumeration Date | 02/23/2009 |
| Last Update Date | 02/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003056698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | LPC004107 (Georgia) | Primary |
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