NPI 1508391756

Mister Life Coach

Organisation Mental Illness Community Based Residential Treatment Facility Decatur, GA

Practice location

Address: 3681 N Decatur Rd APT R11, Decatur, GA 30032-1062
Phone: (631) 553-7131
Mailing address: PO Box 283, Rex, GA 30273-0283

Authorised official

Name: Robert Green
Title: Life Coach
Phone: (631) 553-7131

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

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

Registry record

NPI: 1508391756
Entity type: Organization
NPI issued: 25 Apr 2017
Record last updated: 25 Apr 2017

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.