Organization
MAX EMPOWERMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KISHA P THOMAS M.S. (OWNER/THERAPIST)
(678) 545-0498
Entity
Organization
Contact information
Practice address
217 ARROWHEAD BLVD, SUITE A-4, JONESBORO, GA 30236-1169
(678) 545-0498
Mailing address
PO BOX 296, REX, GA 30273-0296
(678) 545-0498
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC004618
GA
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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