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Organization
LIFE WELLNESS GROUP OF ATLANTA
Active
Organization
LIFE WELLNESS GROUP OF ATLANTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROMAN TARPLIN (OWNER/CEO)
(678) 858-2815
Entity
Organization
Contact information
Practice address
145 WILHEMINA DRIVE, ELLENWOOD, GA 30294
(678) 858-2815
Mailing address
145 WILHEMINA DRIVE, ELLENWOOD, GA 30294
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
253Z00000X
GA
332U00000X
Home Delivered Meals
332U00000X
GA
347C00000X
Private Vehicle
347C00000X
GA
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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