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Organization

THE MEADOWS EDGE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHELLEY B HANKINS LPC (PRESIDENT)
(706) 913-1774
Entity
Organization

Contact information

Practice address
110 W CRAWFORD ST, SUITE 202, DALTON, GA 30720-4201
(706) 913-1774
(706) 529-4199
Mailing address
110 W CRAWFORD ST, SUITE 202, DALTON, GA 30720-4201
(706) 913-1774
(706) 529-4199

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
4989
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4989
LPC
GA
Enumeration date
04/04/2011
Last updated
06/13/2011
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