Organization
GHM2012 CORP.
Active
Organization
GHM2012 CORP.
Active
Other names
Ellie Mental Health Athens
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA BLOOMFIELD KUBIN (OWNER)
(404) 775-5755
Entity
Organization
Contact information
Practice address
700 SUNSET DR STE 302, ATHENS, GA 30606-7721
(404) 775-5755
Mailing address
2522 PARKSIDE DR NE, ATLANTA, GA 30305-3732
(404) 775-5755
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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