Organization
MENTALEASE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA QUEEN (OWNER)
(478) 960-2887
Entity
Organization
Contact information
Practice address
1248 FLINT RD, FORSYTH, GA 31029-6823
(478) 960-2887
(478) 960-2887
Mailing address
1248 FLINT RD, FORSYTH, GA 31029-6823
(478) 960-2887
(478) 960-2887
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/29/2025
Last updated
02/19/2026
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