Organization
KIDS OF GRACE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTOINETTE GOODEN MS, LPC, NCC (EXECUTIVE DIRECTOR)
(404) 604-4226
Entity
Organization
Contact information
Practice address
5262 INVERNESS CT, DOUGLASVILLE, GA 30135-6748
(404) 604-4226
(888) 242-0387
Mailing address
PO BOX 6777, DOUGLASVILLE, GA 30154-0030
(404) 604-4226
(888) 242-0387
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC005074
GA
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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