Organization
MAGNOLIA HEALTH CLINIC
Active
Parent organization
MAGNOLIA BEHAVIORAL HEALTH, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAGNOLIA BEHAVIORAL HEALTH, INC.
Authorized official
DR. MIRA IHEME PH.D., LPC (PRESIDENT)
(770) 724-8093
Entity
Organization
Contact information
Practice address
3350 NORTHLAKE PKWY NE, SUITE B, ATLANTA, GA 30345-2204
(770) 724-8093
Mailing address
3350 NORTHLAKE PKWY NE, SUITE B, ATLANTA, GA 30345-2204
(770) 724-8093
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
00222568
GA
Other
Enumeration date
03/06/2015
Last updated
03/06/2015
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