Organization
SOLID GROUND BEHAVIORAL HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KELLER PMHNP-BC (NURSE PRACTITIONER)
(706) 963-0654
Entity
Organization
Contact information
Practice address
24 CHECHERO ST STE 2, CLAYTON, GA 30525-6181
(706) 963-0654
Mailing address
12244 AUGUSTA RD UNIT 108, LAVONIA, GA 30553-1210
(706) 983-9411
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/23/2025
Last updated
01/23/2025
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