Organization
LIFE ENRICHMENT AND WELLNESS SERVICES
Active
Parent organization
BCMM HEALTH
Other names
Life Link of Louisiana
Organization subpart
Yes
Provider details
NPI number
Legal business name
BCMM HEALTH
Authorized official
MR. CARLOS PORTER (OWNER)
(678) 949-3184
Entity
Organization
Contact information
Practice address
608 STONECREST DRIVE, LOGANVILLE, GA 30052
(678) 949-3184
Mailing address
608 STONECREST DRIVE, LOGANVILLE, GA 30052
(678) 949-3184
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
GA006581
GA
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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