Provider Demographics
NPI:1992083067
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
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-317-2283
Mailing Address - Street 1:837 THURMAN RD
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-1453
Mailing Address - Country:US
Mailing Address - Phone:404-317-2283
Mailing Address - Fax:678-669-2651
Practice Address - Street 1:3665 CLUB DR
Practice Address - Street 2:STE 107
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1806
Practice Address - Country:US
Practice Address - Phone:678-288-6550
Practice Address - Fax:800-609-0965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-24
Last Update Date:2011-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health