| Lydias Small Unique Minds Llc | |
|
312 Render St Lagrange GA 30241-3418 | |
| (706) 883-5801 | |
| Not Available |
| Full Name | Lydias Small Unique Minds Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 312 Render St, Lagrange, Georgia |
| Authorized Official Name and Position | Lydia Tiggs (OWNER) |
| Authorized Official Contact | 7068835801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lydias Small Unique Minds Llc 312 Render St Lagrange GA 30241-3418 Ph: (706) 883-5801 | Lydias Small Unique Minds Llc 312 Render St Lagrange GA 30241-3418 Ph: (706) 883-5801 |
| NPI Number | 1578335618 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 03/27/2024 |
| Certification Date | 03/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578335618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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