| Love, Breanna Olivia Zion Enterprise,llc(lboz): | |
|
9802 N Ivy Park Dr Fortson GA 31808-7130 | |
| (614) 403-7089 | |
| Not Available |
| Full Name | Love, Breanna Olivia Zion Enterprise,llc(lboz): |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9802 N Ivy Park Dr, Fortson, Georgia |
| Authorized Official Name and Position | Brenna Love-cosby (CEO) |
| Authorized Official Contact | 6144037089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Love, Breanna Olivia Zion Enterprise,llc(lboz): 1985 W Henderson Road #2223 Columbus OH 43220 Ph: (614) 403-7089 | Love, Breanna Olivia Zion Enterprise,llc(lboz): 9802 N Ivy Park Dr Fortson GA 31808-7130 Ph: (614) 403-7089 |
| NPI Number | 1699376160 |
|---|---|
| Provider Enumeration Date | 11/02/2020 |
| Last Update Date | 11/02/2020 |
| Certification Date | 11/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699376160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Platypus Vocational & Behavioral Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 181 Hart Preserve Dr, Fortson, GA 31808 Phone: 706-810-0035 | |
Brightside Behavioral Associates, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4443 Ga Highway 219, Fortson, GA 31808 Phone: 762-261-0585 Fax: 706-441-3328 |