| United Family Therapy, Llc | |
|
630 E Church St Jasper GA 30143-1312 | |
| (762) 233-4869 | |
| (706) 510-2654 |
| Full Name | United Family Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 630 E Church St, Jasper, Georgia |
| Authorized Official Name and Position | Hilda Beatriz Grindell (OWNER) |
| Authorized Official Contact | 9548924767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| United Family Therapy, Llc 630 E Church St Jasper GA 30143-1312 Ph: (762) 233-4869 | United Family Therapy, Llc 630 E Church St Jasper GA 30143-1312 Ph: (762) 233-4869 |
| NPI Number | 1356096218 |
|---|---|
| Provider Enumeration Date | 02/18/2022 |
| Last Update Date | 03/26/2023 |
| Certification Date | 03/26/2023 |
| Medicare PECOS PAC ID | 5092101410 |
|---|---|
| Medicare Enrollment ID | O20220411001975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356096218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Hilda B Grindell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780136796 PECOS PAC ID: 5395152474 Enrollment ID: I20210408000843 |
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