# LIFE WELLNESS GROUP OF ATLANTA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235480138
- **Authorized official:** ROMAN TARPLIN (OWNER/CEO)
- **Authorized official phone:** (678) 858-2815

## Contact information

- **Practice address:** 145 WILHEMINA DRIVE, ELLENWOOD, GA 30294
- **Practice address phone:** (678) 858-2815
- **Mailing address:** 145 WILHEMINA DRIVE, ELLENWOOD, GA 30294

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 253Z00000X | GA | Yes |
| 332U00000X | Home Delivered Meals | 332U00000X | GA | — |
| 347C00000X | Private Vehicle | 347C00000X | GA | — |

## Other

- **Enumeration date:** 10/02/2012
- **Last updated:** 10/02/2012