Provider Demographics
NPI:1740687581
Name:GATHERING PRECIOUS STONES, LLC
Entity type:Organization
Organization Name:GATHERING PRECIOUS STONES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:D
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-913-9114
Mailing Address - Street 1:1718 PEACHTREE ST NW
Mailing Address - Street 2:SUITE 481
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2452
Mailing Address - Country:US
Mailing Address - Phone:404-913-9114
Mailing Address - Fax:404-529-4729
Practice Address - Street 1:1718 PEACHTREE ST NW
Practice Address - Street 2:SUITE 481
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2452
Practice Address - Country:US
Practice Address - Phone:404-913-9114
Practice Address - Fax:404-529-4729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty