MISTER LIFE COACH NPI 1619403219

NPI Information

MISTER LIFE COACH is a residential treatment facility emotionally disturbed children in Decatur, GA. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. MISTER LIFE COACH NPI is 1619403219. The provider is registered as an organization entity type.

The provider's business location address is:

3681 N DECATUR RD APT R11
DECATUR, GA
ZIP 30032-062
Phone: (631) 553-7131

The provider's authorized official is Robert Green .
The authorized official title is Life Coach and has the following contact phone number (631) 553-7131.

The enumeration date for this NPI number is 5/3/2017 and was last updated on 5/3/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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