Organization
GROUNDBREAKING GUIDANCE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONI R. MEEKS LPC (OWNER/CLINICIAN)
(770) 910-9162
Entity
Organization
Contact information
Practice address
500 SUN VALLEY DR STE G3, ROSWELL, GA 30076-5639
(770) 910-9162
(770) 910-9768
Mailing address
500 SUN VALLEY DR STE G3, ROSWELL, GA 30076-5639
(770) 910-9162
(770) 910-9768
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184963357
PRIVATE INSURANCE
GA
05
—
1184963357
—
GA
Enumeration date
09/14/2020
Last updated
09/16/2020
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