| Jen's House | |
|
1872 Chedworth Ln Stone Mountain GA 30087-2121 | |
| (770) 733-6004 | |
| Not Available |
| Full Name | Jen's House |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1872 Chedworth Ln, Stone Mountain, Georgia |
| Authorized Official Name and Position | Vernon B. Buckmon (PRESIDENT/GENERAL MANAGER) |
| Authorized Official Contact | 7707336004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jen's House 1872 Chedworth Ln Stone Mountain GA 30087-2121 Ph: (770) 733-6004 | Jen's House 1872 Chedworth Ln Stone Mountain GA 30087-2121 Ph: (770) 733-6004 |
| NPI Number | 1639515992 |
|---|---|
| Provider Enumeration Date | 05/14/2013 |
| Last Update Date | 05/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639515992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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