Organization
POSITIVE IMPACT HEALTH CENTERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA NKOMAZANA (BILLING SPECIALIST)
(404) 589-9040
Entity
Organization
Contact information
Practice address
3350 BRECKINRIDGE BLVD STE 200, DULUTH, GA 30096
(770) 962-8396
(770) 962-1291
Mailing address
3350 BRECKINRIDGE BLVD STE 200, DULUTH, GA 30096-4959
(770) 962-8396
(770) 962-1291
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
024478
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000675342A
—
GA
05
—
536210665A
—
GA
Enumeration date
10/31/2006
Last updated
01/03/2024
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