Provider Demographics
NPI:1881735231
Name:RICHMONT GRADUATE UNIVERSITY
Entity type:Organization
Organization Name:RICHMONT GRADUATE UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEAN OF CLINICAL AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:EVALIN
Authorized Official - Middle Name:RHODES
Authorized Official - Last Name:HANSHEW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-233-3949
Mailing Address - Street 1:2055 MOUNT PARAN RD NW
Mailing Address - Street 2:MCCARTY BUILDING
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2921
Mailing Address - Country:US
Mailing Address - Phone:404-233-3949
Mailing Address - Fax:404-239-9460
Practice Address - Street 1:4200 NORTHSIDE PKWY NW
Practice Address - Street 2:BUILDING FOUR, SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-3054
Practice Address - Country:US
Practice Address - Phone:404-266-0695
Practice Address - Fax:404-239-9460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty