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Organization

INNER COMMUNITY HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIRICA SANDERS DO (OWNER)
(216) 577-3441
Entity
Organization

Contact information

Practice address
2180 SATELLITE BLVD STE 400, DULUTH, GA 30097-4927
(800) 620-6950
(877) 290-0408
Mailing address
2180 SATELLITE BLVD STE 400, DULUTH, GA 30097-4927

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
2084P0800X
Psychiatry Physician
Primary
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003291824A
GA
Enumeration date
11/17/2020
Last updated
11/07/2023
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