Organization
REBIRTH COUNSELING AND TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN HARPE WALLER EDS. (EXECUTIVE DIRECTOR)
(404) 867-3093
Entity
Organization
Contact information
Practice address
3120 S MARTIN ST STE 100, EAST POINT, GA 30344-4396
(678) 705-5698
Mailing address
3120 S MARTIN ST STE 100, EAST POINT, GA 30344-4396
(404) 867-3093
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/10/2012
Last updated
03/05/2024
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