Organization
PARACLETE CHRISTIAN COUNSELING AND EDUCATIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED RICHARD REYNOLDS DMIN (OWNER)
(770) 599-1102
Entity
Organization
Contact information
Practice address
252 SEAVY ST, SENOIA, GA 30276-1806
(770) 599-1102
(770) 599-0806
Mailing address
252 SEAVY ST, P.O. BOX 147, SENOIA, GA 30276-1806
(770) 599-1102
(770) 599-0806
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC001386
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237506833A
—
GA
Enumeration date
11/09/2009
Last updated
11/09/2009
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