Organization
PENTA C. ENTERPRICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE CANNON (DIRECTOR)
(404) 243-1992
Entity
Organization
Contact information
Practice address
3009 RAINBOW DR, 142, DECATUR, GA 30034-1680
(404) 243-1992
(404) 243-4903
Mailing address
3009 RAINBOW DR, 142, DECATUR, GA 30034-1680
(404) 243-1992
(404) 243-4903
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YM0800X
GA
Other
Enumeration date
07/03/2007
Last updated
08/22/2020
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