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Organization

AMODESTRI ASSOCIATES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NA'KEYA C THOMAS (OWNER/DIRECTOR)
(678) 334-6381
Entity
Organization

Contact information

Practice address
11780 HASTINGS BRIDGE RD, HAMPTON, GA 30228-6271
(678) 334-6381
Mailing address
11780 HASTINGS BRIDGE RD, HAMPTON, GA 30228-6271
(678) 334-6381

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
164W00000X
Licensed Practical Nurse
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
02/19/2016
Last updated
05/27/2021
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