Organization
PEACHTREE HEALTHCARE LLC
Active
Other names
Peachtree Healthcare LLC
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY PATTERSON-HARVEY (CEO)
(706) 825-6089
Entity
Organization
Contact information
Practice address
5060 N 19TH AVE STE 421, PHOENIX, AZ 85015-3214
(706) 825-6089
Mailing address
5060 N 19TH AVE STE 421, PHOENIX, AZ 85015-3214
(706) 825-6089
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
11/28/2022
Last updated
09/05/2023
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