Provider Demographics
NPI:1043456908
Name:NEW JOSHUAS CIRCLE OF HOPE FOR MENTAL WELLNESS & RECOVERY
Entity Type:Organization
Organization Name:NEW JOSHUAS CIRCLE OF HOPE FOR MENTAL WELLNESS & RECOVERY
Other - Org Name:NJCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:LAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-671-7675
Mailing Address - Street 1:201 THICKET WAY
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3700
Mailing Address - Country:US
Mailing Address - Phone:404-671-7675
Mailing Address - Fax:
Practice Address - Street 1:201 THICKET WAY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3700
Practice Address - Country:US
Practice Address - Phone:404-671-7675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-25
Last Update Date:2008-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00214239261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)