Provider Demographics
NPI:1508590100
Name:LAUER ENTERPRISES LLC
Entity Type:Organization
Organization Name:LAUER ENTERPRISES LLC
Other - Org Name:ELLIE MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-365-8275
Mailing Address - Street 1:2535 WENTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6522
Mailing Address - Country:US
Mailing Address - Phone:770-365-8275
Mailing Address - Fax:
Practice Address - Street 1:925 WOODSTOCK RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2206
Practice Address - Country:US
Practice Address - Phone:770-365-8275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty