Provider Demographics
NPI:1245914050
Name:POSITIVE MIND HEALTHCARE LLC
Entity type:Organization
Organization Name:POSITIVE MIND HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABIMBOLA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:ALUKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-367-9167
Mailing Address - Street 1:2201 DERBYSHIRE DR SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-6019
Mailing Address - Country:US
Mailing Address - Phone:678-367-9167
Mailing Address - Fax:
Practice Address - Street 1:2201 DERBYSHIRE DR SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-6019
Practice Address - Country:US
Practice Address - Phone:678-367-9167
Practice Address - Fax:770-977-7840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty