| Kesha Green Llc | |
|
122 Greystone Cir Hiram GA 30141-3141 | |
| (706) 332-0526 | |
| Not Available |
| Full Name | Kesha Green Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 122 Greystone Cir, Hiram, Georgia |
| Authorized Official Name and Position | Kesha Panika Green (OWNER/CLINICIAN) |
| Authorized Official Contact | 7063320526 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kesha Green Llc 122 Greystone Cir Hiram GA 30141-3141 Ph: () - | Kesha Green Llc 122 Greystone Cir Hiram GA 30141-3141 Ph: (706) 332-0526 |
| NPI Number | 1568734556 |
|---|---|
| Provider Enumeration Date | 02/06/2012 |
| Last Update Date | 02/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568734556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Georgia) | Primary |
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