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Organization
EMBERS OF PEACE & WELLNESS LLC
Active
Organization
EMBERS OF PEACE & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATASHA RACHELE JACKSON MSN, APRN, PMHNP-BC (OWNER)
(943) 300-5764
Entity
Organization
Contact information
Practice address
1870 THE EXCHANGE SE, ATLANTA, GA 30339-2036
(943) 300-5764
Mailing address
1870 THE EXCHANGE SOUTH EAST, STE 220 PMB 228776, ATLANTA, GA 30339-2036
(943) 300-5764
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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