Provider Demographics
NPI:1790393684
Name:RECLAIMU HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:RECLAIMU HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:678-568-9377
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-0220
Mailing Address - Country:US
Mailing Address - Phone:678-568-9377
Mailing Address - Fax:
Practice Address - Street 1:2037 EMA DELL PL
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-5375
Practice Address - Country:US
Practice Address - Phone:678-568-9377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty