Organization
NEW ABUNDANT LIVING PCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIARA BARBER-BOYNES (ADMINISTRATOR/OWNER)
(404) 290-5029
Entity
Organization
Contact information
Practice address
3887 SABLE DR, STONE MOUNTAIN, GA 30083-4443
(404) 290-5029
Mailing address
3887 SABLE DR, STONE MOUNTAIN, GA 30083-4443
(404) 290-5029
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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