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Organization

CREATIVE MINDS FOR WELLNESS, LLC

Active
Parent organization
CREATIVE CENTER FOR WELLNESS, INCOORPORATED
Organization subpart
Yes

Provider details

NPI number
Legal business name
CREATIVE CENTER FOR WELLNESS, INCOORPORATED
Authorized official
MANDY MICHELLE MILLER LCSW (COO)
(912) 200-7608
Entity
Organization

Contact information

Practice address
125 LEE BYRD RD, LOGANVILLE, GA 30052-2310
(770) 599-7512
Mailing address
4160 LOGAN DR UNIT 3261, LOGANVILLE, GA 30052-9531
(770) 599-7512

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
CSW004354
GA
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
03/03/2018
Last updated
03/03/2018
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