Provider Demographics
NPI:1609922871
Name:BEATRICE A. SANTELLI, INC.
Entity Type:Organization
Organization Name:BEATRICE A. SANTELLI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-785-2783
Mailing Address - Street 1:7342 FIREFLY CT
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-4078
Mailing Address - Country:US
Mailing Address - Phone:770-785-2783
Mailing Address - Fax:
Practice Address - Street 1:5510 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-5686
Practice Address - Country:US
Practice Address - Phone:770-785-2783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALMFT000924106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty