Organization
BY GRACE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TISA MACKLIN-STANLEY (PROVIDER)
(404) 827-8038
Entity
Organization
Contact information
Practice address
100 HEMINGWAY LN, ROSWELL, GA 30075-7024
(470) 765-8393
Mailing address
734 HEMINGWAY LN, ROSWELL, GA 30075-7006
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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