Organization
VILLAGE LIFE,LLC
Active
Organization
VILLAGE LIFE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIA GARRET LCSW (FOUNDER/PROGRAM DEVELOPER)
(404) 353-2227
Entity
Organization
Contact information
Practice address
569 GRANITE CT, LAWRENCEVILLE, GA 30044-6931
(404) 353-2227
Mailing address
569 GRANITE CT, LAWRENCEVILLE, GA 30044-6931
(404) 353-2227
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSW005893
GA
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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