Whalio Doctors

NPI 1427199199

Integrated Life Center, INC.

Organisation Mental Illness Community Based Residential Treatment Facility Stone Mountain, GA

Practice location

Address
4641 Stonegate Industrial Blvd, Stone Mountain, GA 30083-1908
Phone
(404) 377-5556
Fax
(404) 292-9903

Authorised official

Name
Dennis Arthur O'Brien
Title
Ceo
Phone
(404) 377-5556

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320800000X Licence 025893 (GA)

Registry record

NPI
1427199199
Entity type
Organization
NPI issued
8 Feb 2007
Record last updated
21 Nov 2011

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.