Latella, Mike
Latella, Mike is an sole proprietor health care provider with primary practice located at 111 Petrol Pt Ste A-3 , Peachtree City GA 30269-1550. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Latella, Mike can be contacted via phone (678) 568-9049.Contact Information
Primary practice address
111 Petrol Pt Ste A-3
Peachtree City GA 30269-1550
Phone: (678) 568-9049
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1241 | Georgia |
Profile Details
| NPI number | 1629624382 |
|---|---|
| LBN Legal business name | Latella, Mike |
| Credentials | CADC-II |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2019 |
| Last updated | Aug 16th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629624382 | NPPES |
| Georgia | Other | 3918 | GA CERTIFIED DRUG AND ALCOHOL EVALUATOR NUMBER |
| Georgia | Other | EO56 | GA CERTIFIED DRUG AND ALCOHOL EVALUATOR NUMBER |
| Georgia | Other | 1241 | GA CERTIFIED DRUG AND ALCOHOL EVALUATOR NUMBER |
| Georgia | Other | 809429 | GA CERTIFIED DRUG AND ALCOHOL EVALUATOR NUMBER |
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