Organization
RECONCILIATION MOVEMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE BENTON LPC (PRESIDENT/BOARD MEMBER)
(404) 969-5661
Entity
Organization
Contact information
Practice address
640 HIGHWAY 138 SW, RIVERDALE, GA 30274-3908
(404) 969-5661
(404) 795-8974
Mailing address
PO BOX 741125, RIVERDALE, GA 30274-1300
(404) 969-5661
(404) 795-8974
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
11/30/2017
Last updated
06/11/2019
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