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Organization

THE LIGHTED ROAD COUNSELING CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SIMONNE DUPRE M.D. (CEO)
(678) 232-8938
Entity
Organization

Contact information

Practice address
7444 HANNOVER PKWY S, SUITE 200, STOCKBRIDGE, GA 30281-9303
(678) 232-8938
Mailing address
7444 HANNOVER PKWY S, SUITE 200, STOCKBRIDGE, GA 30281-9303
(678) 232-8938

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
09/02/2011
Last updated
09/02/2011
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