Integrated Life Center, Inc. in Stone Mountain - Community Based Residential Treatment Facility, Mental Illness
Integrated Life Center, Inc. - NPI 1427199199
Integrated Life Center, Inc. is a Community Based Residential Treatment Facility, Mental Illness in Stone Mountain, Georgia. Integrated Life Center, Inc. practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Integrated Life Center, Inc. is 1427199199. The last update date is 2011-11-21.
Integrated Life Center, Inc.'s current location address is 4641 Stonegate Industrial Blvd, Stone Mountain, Georgia. You can contact this provider via phone number 4043775556 and fax number 4042920093. The mailing address for Integrated Life Center, Inc. is 4641 Stonegate Industrial Blvd, Stone Mountain, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Integrated Life Center, Inc. |
|---|---|
| Address | 4641 Stonegate Industrial Blvd, Stone Mountain, Georgia |
| Phone Number | 4043775556 |
| Fax Number | 4042920093 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | O'Brien Arthur Dennis |
| Credentials | M.D. |
| Telephone Number | 4043775556 |
NPI Number Detail
| NPI Number | 1427199199 |
|---|---|
| Provider Enumeration Date | 2007-02-08 |
| Last Updated Date | 2011-11-21 |
Provider Mailing Address Detail
| Address | 4641 Stonegate Industrial Blvd |
|---|---|
| City | Stone Mountain |
| State | Georgia (GA) |
| Post Code | 300831908 |
| Phone Number | 4043775556 |
| Fax Number | 4042920093 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
| Licence No | 25893 |
|
Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00921324A | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Integrated Life Center, Inc. by the Centers for Medicare & Medicaid Services?
The Integrated Life Center, Inc. has been issued the NPI (National Provider Identifier) 1427199199 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Integrated Life Center, Inc.'s physical address?
The Integrated Life Center, Inc. is physically located at 4641 Stonegate Industrial Blvd, in the city of Stone Mountain, GA, with the postal code 300831908.
What is Integrated Life Center, Inc.'s specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Integrated Life Center, Inc.'s specialized field of practice is Community Based Residential Treatment Facility, Mental Illness, and the corresponding taxonomy code that categorizes this area of specialization is 320800000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1427199199 to Integrated Life Center, Inc.?
The Integrated Life Center, Inc. received its 1427199199 assignment from the Centers for Medicare & Medicaid Services on 2007-02-08.
When was the Integrated Life Center, Inc.'s information last updated?
The Integrated Life Center, Inc.'s information was last updated on 2011-11-21.