| NPI | 1912770017 |
|---|---|
| Former Legal Business Name | BLACKSTONE VENTURES LLC |
| Entity Type | Organization |
| Authorized Contact | JIMMY-SHAROD TATE CFO 678-927-4710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2023-12-21 |