Provider Demographics
NPI:1407730005
Name:ATHENA INTEGRATIVE HEALTH SOLUTIONS
Entity type:Organization
Organization Name:ATHENA INTEGRATIVE HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PEARL
Authorized Official - Middle Name:AKU
Authorized Official - Last Name:AMOAKO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:470-567-0215
Mailing Address - Street 1:850 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7218
Mailing Address - Country:US
Mailing Address - Phone:470-567-0215
Mailing Address - Fax:470-264-1399
Practice Address - Street 1:2639 LONGACRE PARK WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-1536
Practice Address - Country:US
Practice Address - Phone:470-567-0215
Practice Address - Fax:470-264-1399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service