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Organization

HEALTH REJUVENATIONS CONSULTANT, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DORIS D'NIN PATILLO PSYD. L.P.C., CACII (CEO-PSYCHOLOGIST)
(404) 731-6107
Entity
Organization

Contact information

Practice address
194 JONESBORO RD, SUITE A-6, JONESBORO, GA 30236-4812
(404) 731-6107
(404) 366-9947
Mailing address
4588 BOULDERCREST RD, ELLENWOOD, GA 30294-3613
(404) 731-6107
(404) 366-9947

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1594
GA
251S00000X
Community/Behavioral Health Agency
Primary
004196
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01068080
AMERIGROUP CORPORATION
GA
Enumeration date
04/09/2007
Last updated
06/08/2011
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