Provider Demographics
NPI:1629831607
Name:ATLANTA NEUROHEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:ATLANTA NEUROHEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-669-1424
Mailing Address - Street 1:4045 VININGS MILL CT SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6499
Mailing Address - Country:US
Mailing Address - Phone:470-669-1424
Mailing Address - Fax:404-400-4970
Practice Address - Street 1:400 GALLERIA PKWY SE STE 1500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5953
Practice Address - Country:US
Practice Address - Phone:470-669-1424
Practice Address - Fax:404-400-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty