Organization
BOH MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIYANBOLA AJAO (OWNER)
(515) 531-5175
Entity
Organization
Contact information
Practice address
1800 PHOENIX BLVD, ATLANTA, GA 30349-5593
(515) 531-5175
Mailing address
1800 PHOENIX BLVD, ATLANTA, GA 30349-5593
(515) 531-5175
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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