Organization
ENRICHMENT FOR LIFE PCC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY ANN MCWILSON (PRESIDENT)
(770) 987-0897
Entity
Organization
Contact information
Practice address
3080 SNAPFINGER RD, DECATUR, GA 30034-3624
(770) 987-0897
(404) 288-9325
Mailing address
3080 SNAPFINGER RD, DECATUR, GA 30034-3624
(770) 987-0897
(404) 288-9325
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
044-01-434-1
GA
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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