| Kennesaw State University Health Clinic | |
|
1000 Chastain Rd Nw House 52 Kennesaw GA 30144-5588 | |
| (770) 423-6644 | |
| Not Available |
| Full Name | Kennesaw State University Health Clinic |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1000 Chastain Rd Nw, Kennesaw, Georgia |
| Authorized Official Name and Position | Anne Nichols (HEALTH CLINIC DIRECTOR) |
| Authorized Official Contact | 7704236644 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennesaw State University Health Clinic 1000 Chastain Rd Nw House 52 Kennesaw GA 30144-5588 Ph: (770) 423-6644 | Kennesaw State University Health Clinic 1000 Chastain Rd Nw House 52 Kennesaw GA 30144-5588 Ph: (770) 423-6644 |
| NPI Number | 1831426931 |
|---|---|
| Provider Enumeration Date | 11/10/2009 |
| Last Update Date | 11/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831426931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | RN057224 (Georgia) | Primary |
| 261QS1000X | Clinic/center - Student Health | RN057224 (Georgia) | Secondary |
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