| My Associates,llc | |
|
1869 Wicks Valley Drive Marietta GA 30062 | |
| (678) 404-1131 | |
| Not Available |
| Full Name | My Associates,llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1869 Wicks Valley Drive, Marietta, Georgia |
| Authorized Official Name and Position | Thomas Clark (PRESIDENT) |
| Authorized Official Contact | 6784041131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Associates,llc P.o. Box 73021 Marietta GA 30007-3021 Ph: (678) 404-1131 | My Associates,llc 1869 Wicks Valley Drive Marietta GA 30062 Ph: (678) 404-1131 |
| NPI Number | 1194120014 |
|---|---|
| Provider Enumeration Date | 11/04/2014 |
| Last Update Date | 10/12/2022 |
| Certification Date | 10/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194120014 | NPI | - | NPPES |
| 999999999999 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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