Organization
GOLD COAST CONSULTING LLC
Active
Other names
Gold Coast Consulting LLC, Phoenix Rising
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COREY T PRICE (OWNER)
(678) 709-9021
Entity
Organization
Contact information
Practice address
101 DEVANT ST STE 503, FAYETTEVILLE, GA 30214-2720
(770) 282-6962
(770) 282-6962
Mailing address
101 DEVANT ST STE 503, FAYETTEVILLE, GA 30214-2720
(770) 282-6962
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000000000000
NOT APPLICABLE
—
Enumeration date
06/13/2022
Last updated
06/13/2022
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