Provider Demographics
NPI:1457074403
Name:PERSPECTIVE MENTAL HEALTH AND ADDICTION, LLC
Entity Type:Organization
Organization Name:PERSPECTIVE MENTAL HEALTH AND ADDICTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SUBSTANCE ABUSE COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DONTE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:CADCII
Authorized Official - Phone:678-488-9563
Mailing Address - Street 1:640 OAKMONT HL
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5744
Mailing Address - Country:US
Mailing Address - Phone:678-488-9563
Mailing Address - Fax:
Practice Address - Street 1:500 SUN VALLEY DR STE G2
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5639
Practice Address - Country:US
Practice Address - Phone:678-488-9563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)