Organization
PRIME TREATMENT & WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OGOCHUKWU OJIAKU (PROVIDER/OWNER)
(404) 457-3743
Entity
Organization
Contact information
Practice address
165 AVONLEA DR, COVINGTON, GA 30016-1226
(678) 235-8934
Mailing address
165 AVONLEA DR, COVINGTON, GA 30016-1226
(678) 235-8934
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/02/2024
Last updated
09/02/2024
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