Organization
RENEWED & RESTORED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY M HARRIS LPC, NCC, CPCS (OWNER)
(678) 849-4777
Entity
Organization
Contact information
Practice address
2531 BRIARCLIFF RD NE STE 203, ATLANTA, GA 30329-3017
(678) 849-4777
Mailing address
2218 RUGBY AVE, ATLANTA, GA 30337-1019
(678) 849-4777
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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