Organization
LIFE EVOLUTIONS BEHAVIORAL HEALTH CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATASHA MURRAY (OWNER/EXECUTIVE DIRECTOR)
(404) 636-4346
Entity
Organization
Contact information
Practice address
2598 N DECATUR RD, DECATUR, GA 30033-6118
(404) 636-5346
Mailing address
PO BOX 83339, CONYERS, GA 30013-8019
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SLP006065
GA
Other
Enumeration date
06/07/2009
Last updated
06/07/2009
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