Provider Demographics
NPI:1508311788
Name:MENTAL WELLNESS MATTERS TREATMENT CENTER, LLC
Entity Type:Organization
Organization Name:MENTAL WELLNESS MATTERS TREATMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-334-5944
Mailing Address - Street 1:5526 FLAT SHOALS PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-5430
Mailing Address - Country:US
Mailing Address - Phone:770-696-2971
Mailing Address - Fax:
Practice Address - Street 1:5526 FLAT SHOALS PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-5430
Practice Address - Country:US
Practice Address - Phone:770-696-2971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty