Organization
RENEW AND LIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA ROCHELLE GRAHAM RN, BSN, CDE (OWNER/PROGRAM COORDINATOR)
(404) 396-4417
Entity
Organization
Contact information
Practice address
438 GRAYSON PKWY, GRAYSON, GA 30017-1219
(404) 396-4417
Mailing address
2250 OAK RD UNIT 1541, SNELLVILLE, GA 30078-1914
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
—
—
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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