Organization
HEALTHY MIND - FULL LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDALL L BLAKE LCSW (OWNER)
(202) 352-5891
Entity
Organization
Contact information
Practice address
1778 CENTURY BLVD NE STE A, ATLANTA, GA 30345-3398
(202) 352-5891
Mailing address
1778 CENTURY BLVD NE STE A, ATLANTA, GA 30345-3398
(202) 352-5891
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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