Organization
MY ASSOCIATES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS CLARK (PRESIDENT)
(678) 404-1131
Entity
Organization
Contact information
Practice address
1869 WICKS VALLEY DRIVE, MARIETTA, GA 30062
(678) 404-1131
Mailing address
P.O. BOX 73021, MARIETTA, GA 30007-3021
(678) 404-1131
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
999999999999
—
GA
Enumeration date
11/04/2014
Last updated
10/12/2022
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