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Organization

ANTIOCH CHRISTIAN CENTER, INC

Active
Other names
Behavioral Health Services, Rehab, Healthcare Provider, Counseling
Organization subpart
No

Provider details

NPI number
Authorized official
PAMELA RICHARDSON (ADMINISTRATOR)
(313) 805-5386
Entity
Organization

Contact information

Practice address
2879 HERITAGE OAKS CIR, DACULA, GA 30019-7082
(313) 805-5386
Mailing address
2879 HERITAGE OAKS CIR, DACULA, GA 30019-7082
(313) 805-5386

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
103T00000X
Psychologist
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
106H00000X
Marriage & Family Therapist
171M00000X
Case Manager/Care Coordinator
171W00000X
Contractor
172A00000X
Driver
172V00000X
Community Health Worker
174H00000X
Health Educator

Other

Enumeration date
08/14/2023
Last updated
08/14/2023
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