Organization
MQA ENRICHMENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE WIGGINS (CEO)
(919) 710-4252
Entity
Organization
Contact information
Practice address
5300 MEMORIAL DR STE 121, STONE MOUNTAIN, GA 30083-3154
(919) 710-4252
Mailing address
PO BOX 634, WILMINGTON, NC 28402-0634
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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