Provider Demographics
NPI:1245089945
Name:ACCEPTANCE AND HEALING THERAPY CENTER, LLC
Entity type:Organization
Organization Name:ACCEPTANCE AND HEALING THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYTREONA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:478-284-8636
Mailing Address - Street 1:105 WANDA DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31028-1469
Mailing Address - Country:US
Mailing Address - Phone:478-284-8636
Mailing Address - Fax:
Practice Address - Street 1:1302 WATSON BLVD # 1107
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3436
Practice Address - Country:US
Practice Address - Phone:773-887-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)