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Organization
OUT THE BLUE, LLC
Active
Organization
OUT THE BLUE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE C DEW LCSW (CEO)
(404) 625-2841
Entity
Organization
Contact information
Practice address
5 CONCOURSE PKWY, ATLANTA, GA 30328-5350
(470) 827-7356
Mailing address
8205 SAINT CLAIR DR NE, ATLANTA, GA 30329-2686
(404) 625-2841
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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