Provider Demographics
NPI:1891380036
Name:UNITEDHANDS MENTAL & BEHAVIORAL HEALTH CLINIC INC.,
Entity Type:Organization
Organization Name:UNITEDHANDS MENTAL & BEHAVIORAL HEALTH CLINIC INC.,
Other - Org Name:UNITEDHANDS MENTAL & BEHAVIORAL HEALTH INC,
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NP-C
Authorized Official - Prefix:
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHOU
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:770-703-3549
Mailing Address - Street 1:1115 MOUNT ZION RD STE J
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-2266
Mailing Address - Country:US
Mailing Address - Phone:770-703-3549
Mailing Address - Fax:531-200-7387
Practice Address - Street 1:1115 MOUNT ZION RD STE J
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2266
Practice Address - Country:US
Practice Address - Phone:770-703-3549
Practice Address - Fax:531-200-7387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health