Organization
KELLY'S LIFE CENTER
Active
Organization
KELLY'S LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESSA DOUGLAS (OWNER)
(404) 228-7985
Entity
Organization
Contact information
Practice address
3895 TOLLIVER HILLS DR, ELLENWOOD, GA 30294-1209
(404) 228-7985
(404) 963-7812
Mailing address
1616 COLUMBIA DR, DECATUR, GA 30032-4613
(404) 228-7985
(404) 963-7812
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
031012958
GA
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
031012958
GA
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up