Organization
BRILLIANCE REVEALED MENTAL HEALTH, INC.
Active
Organization
BRILLIANCE REVEALED MENTAL HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EUGENIA LARTEY-ATTIGAH LPC (OWNER)
(678) 507-0900
Entity
Organization
Contact information
Practice address
1700 PENNSYLVANIA AVE, MCDONOUGH, GA 30253-9115
(648) 507-0900
(678) 507-0901
Mailing address
2336 HACKAMORE DR, COLLEGE PARK, GA 30349-4383
(678) 507-0900
(678) 507-0901
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC09991
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710487384
BEHAVIORAL HEALTH
GA
Enumeration date
06/22/2018
Last updated
06/11/2019
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