Organization
GENTLE CARE BEHAVIORAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOYIA JACKSON PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
(404) 999-4726
Entity
Organization
Contact information
Practice address
320 LANIER AVE W, STE 200, FAYETTEVILLE, GA 30214
(404) 999-4726
Mailing address
320 LANIER AVE W STE 200, FAYETTEVILLE, GA 30214-7443
(404) 999-4726
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/22/2021
Last updated
11/12/2021
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