| Purpose Community Therapeutic Services, Llc | |
|
242 Fairfield Rd Villa Rica GA 30180-3804 | |
| (770) 280-7288 | |
| (770) 983-6098 |
| Full Name | Purpose Community Therapeutic Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 242 Fairfield Rd, Villa Rica, Georgia |
| Authorized Official Name and Position | Chantay Golson (CEO) |
| Authorized Official Contact | 7702807288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purpose Community Therapeutic Services, Llc 3400 Chapel Hill Rd Suite 216 Douglasville GA 30135-1739 Ph: (770) 280-7288 | Purpose Community Therapeutic Services, Llc 242 Fairfield Rd Villa Rica GA 30180-3804 Ph: (770) 280-7288 |
| NPI Number | 1851632376 |
|---|---|
| Provider Enumeration Date | 03/07/2013 |
| Last Update Date | 03/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851632376 | NPI | - | NPPES |
| 003126621A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 002683 (Georgia) | Primary |
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