Organization
HERITAGE CARE PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR AKINOLA (OWNER)
(470) 726-4147
Entity
Organization
Contact information
Practice address
135 EAGLES WALK STE 100, STOCKBRIDGE, GA 30281-7205
(470) 726-4147
Mailing address
135 EAGLES WALK STE 100, STOCKBRIDGE, GA 30281-7205
(470) 726-4147
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
04/26/2024
Last updated
08/05/2024
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