| Mind Restoration, Llc | |
|
3545 Broad St Unit 660156 Atlanta GA 30366-2123 | |
| (404) 275-4604 | |
| Not Available |
| Full Name | Mind Restoration, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3545 Broad St Unit 660156, Atlanta, Georgia |
| Authorized Official Name and Position | Adam Mctighe (OWNER/PARTNER) |
| Authorized Official Contact | 4129512483 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Restoration, Llc 3545 Broad St Unit 660156 Atlanta GA 30366-2123 Ph: (404) 275-4604 | Mind Restoration, Llc 3545 Broad St Unit 660156 Atlanta GA 30366-2123 Ph: (404) 275-4604 |
| NPI Number | 1619753274 |
|---|---|
| Provider Enumeration Date | 09/07/2023 |
| Last Update Date | 09/07/2023 |
| Certification Date | 09/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619753274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
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