Provider Demographics
NPI:1851082200
Name:CDG ENTERPRISES, LLC
Entity Type:Organization
Organization Name:CDG ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:DIONE
Authorized Official - Last Name:GRIER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-880-9470
Mailing Address - Street 1:532 HOLICK AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-4339
Mailing Address - Country:US
Mailing Address - Phone:770-880-9470
Mailing Address - Fax:404-891-4140
Practice Address - Street 1:203 S WATER ST STE 208
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7226
Practice Address - Country:US
Practice Address - Phone:770-231-4792
Practice Address - Fax:404-891-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)