Organization
CAVA WELLNESS TELEHEALTH INC.
Active
Other names
Blackstone Ventures LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY-SHAROD TATE (CFO)
(678) 927-4710
Entity
Organization
Contact information
Practice address
8735 DUNWOODY PL # 4867, ATLANTA, GA 30350-2995
(770) 268-2539
Mailing address
8735 DUNWOODY PL # 4867, ATLANTA, GA 30350-2995
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
12/21/2023
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