Provider Demographics
NPI:1225242803
Name:AMATE, LTD.
Entity Type:Organization
Organization Name:AMATE, LTD.
Other - Org Name:INT. CENTER FOR MEDIATED LEARNING COGNITIVE EDUCATION SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOGENS
Authorized Official - Middle Name:REIMER
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-640-1650
Mailing Address - Street 1:300 COLONIAL CENTER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4899
Mailing Address - Country:US
Mailing Address - Phone:770-640-1650
Mailing Address - Fax:
Practice Address - Street 1:800 OLD ROSWELL LAKES PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1667
Practice Address - Country:US
Practice Address - Phone:770-640-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001343103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty