Organization
MINDCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAGDANA PHILOSSAINT PHD (LICENSED CLINICAL SOCIAL WORKER)
(678) 826-7554
Entity
Organization
Contact information
Practice address
9991 COMMERCE ST., SUMMERVILLE, GA 30747
(404) 556-4799
Mailing address
7886 DRY CREEK RD, SUMMERVILLE, GA 30747-6851
(678) 876-7554
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
CSW004690
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124139B
—
GA
Enumeration date
05/23/2012
Last updated
12/04/2020
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