Organization
PANACEA COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLTON GRAY (CO-FOUNDER)
(404) 723-4644
Entity
Organization
Contact information
Practice address
1436 KING RD, RIVERDALE, GA 30296-2915
(404) 510-9358
Mailing address
5436 GLEN HAVEN DR, COLLEGE PARK, GA 30349-6481
(404) 936-3126
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC005841
GA
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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