Provider Demographics
NPI:1770716268
Name:CHOCOLATE HEALING ARTS CENTER
Entity type:Organization
Organization Name:CHOCOLATE HEALING ARTS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PURCELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-532-3178
Mailing Address - Street 1:PO BOX 6842
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-1088
Mailing Address - Country:US
Mailing Address - Phone:770-532-3178
Mailing Address - Fax:
Practice Address - Street 1:4006 MUNDY MILL RD
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:GA
Practice Address - Zip Code:30566-2807
Practice Address - Country:US
Practice Address - Phone:770-532-3178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004338251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health