Organization
THE MARGIE REE HANSFORD THURMOND FAMILY LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRNA THURMOND MALONE CPC (CLINICAL DIRECTOR)
(770) 468-7100
Entity
Organization
Contact information
Practice address
710 KING RD, RIVERDALE, GA 30274-2027
(770) 468-7100
Mailing address
9100 AMBERLEIGH LN, RIVERDALE, GA 30274-4682
(770) 468-7100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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