NPI 1144521428

Kelly's Life Center

Organisation Mental Illness Community Based Residential Treatment Facility Ellenwood, GA

Practice location

Address: 3895 Tolliver Hills Dr, Ellenwood, GA 30294-1209
Phone: (404) 228-7985
Fax: (404) 963-7812
Mailing address: 1616 Columbia Dr, Decatur, GA 30032-4613

Authorised official

Name: Teressa Douglas
Title: Owner
Phone: (404) 228-7985

Registered specialties (2)

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 031012958 (GA)

Other Community Based Residential Treatment Facility, Mental Illness providers in Georgia →

Assisted Living Facility

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 031012958 (GA)

Other Assisted Living Facility providers in Georgia →

Registry record

NPI: 1144521428
Entity type: Organization
NPI issued: 3 Nov 2010
Record last updated: 3 Nov 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.