Organization
ADVANCED JUVENILE ENHANCEMENT, LLC
Active
Other names
ADVANCED JUVENILE ENHANCEMENT, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA SOLOMON LCSW (OWNER)
(478) 320-7837
Entity
Organization
Contact information
Practice address
3058 ROLLING RD N, MACON, GA 31204-1077
(478) 320-7837
Mailing address
3058 ROLLING RD N, MACON, GA 31204-1077
(478) 320-7837
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
05
—
003246411A
—
GA
Enumeration date
04/23/2021
Last updated
05/21/2023
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