Provider Demographics
NPI:1326122870
Name:KAIROS: FOLLOWING THE HEART
Entity Type:Organization
Organization Name:KAIROS: FOLLOWING THE HEART
Other - Org Name:THE HOLISTIC CENTER FOR CONSCIOUS GROWTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAGRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:706-951-7836
Mailing Address - Street 1:753 BROAD ST STE 405
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-1385
Mailing Address - Country:US
Mailing Address - Phone:706-951-7836
Mailing Address - Fax:706-828-6616
Practice Address - Street 1:753 BROAD ST STE 405
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-1385
Practice Address - Country:US
Practice Address - Phone:706-951-7836
Practice Address - Fax:706-828-6616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002748103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA531556853AMedicare ID - Type Unspecified