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Organization

MENTAL SPACE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA STRINGFIELD (OWNER)
(706) 619-1390
Entity
Organization

Contact information

Practice address
4408 COLUMBIA RD STE 104, MARTINEZ, GA 30907-4561
(707) 819-1390
Mailing address
PO BOX 44163, GOODFELLOW AFB, TX 76908-0163
(706) 619-1390
(505) 370-4730

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
12/10/2019
Last updated
11/18/2021
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