Provider Demographics
NPI:1003615972
Name:THE EMOTIONAL HOSPITAL
Entity type:Organization
Organization Name:THE EMOTIONAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:LEANA
Authorized Official - Last Name:BENTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-453-9497
Mailing Address - Street 1:1420 WHITE ROCKS WAY
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-7126
Mailing Address - Country:US
Mailing Address - Phone:404-453-9497
Mailing Address - Fax:
Practice Address - Street 1:1420 WHITE ROCKS WAY
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-7126
Practice Address - Country:US
Practice Address - Phone:404-453-9497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)