Individual
MS. MATHILDA PREVOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1741 HIGHWAY 138 SW, RIVERDALE, GA 30296-1921
(770) 996-5552
Mailing address
1741 HIGHWAY 138 SW, RIVERDALE, GA 30296-1921
(770) 996-5552
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
031012331
GA
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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