| Peacewerks Center For Well-being | |
|
5420 Red Berry Ln Sw Atlanta GA 30331-7750 | |
| (678) 296-8687 | |
| Not Available |
| Full Name | Peacewerks Center For Well-being |
|---|---|
| Speciality | Social Worker |
| Location | 5420 Red Berry Ln Sw, Atlanta, Georgia |
| Authorized Official Name and Position | Mary Polly Boyd (CEO) |
| Authorized Official Contact | 6782968687 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peacewerks Center For Well-being 5420 Red Berry Ln Sw Atlanta GA 30331-7750 Ph: (678) 296-8687 | Peacewerks Center For Well-being 5420 Red Berry Ln Sw Atlanta GA 30331-7750 Ph: (678) 296-8687 |
| NPI Number | 1295032126 |
|---|---|
| Provider Enumeration Date | 02/10/2011 |
| Last Update Date | 12/06/2013 |
| Medicare PECOS PAC ID | 5698904928 |
|---|---|
| Medicare Enrollment ID | O20140922001788 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295032126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW004387 (Georgia) | Primary |
| Provider Name | Mary P Boyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750710539 PECOS PAC ID: 8224267554 Enrollment ID: I20140922002059 |
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