Organization
MAGNOLIA BEHAVIORAL HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRA MIRA IHEME PH.D. (PRESIDENT)
(770) 724-8093
Entity
Organization
Contact information
Practice address
3350 NORTHLAKE PKWY NE, ATLANTA, GA 30345-2204
(770) 724-8093
Mailing address
3350 NORTHLAKE PKWY NE, ATLANTA, GA 30345-2204
(770) 724-8093
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
GA
Other
Enumeration date
01/04/2013
Last updated
01/04/2013
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