Organization
GEORGIA COMPASSION COLLECTIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY CIANCIOLO LPC (OWNER)
(504) 295-9312
Entity
Organization
Contact information
Practice address
209 SWANTON WAY STE 204B, DECATUR, GA 30030-3274
(504) 295-9312
Mailing address
1977 CAMELLIA DR, DECATUR, GA 30032-5205
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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