Organization
LIFE INTERVENTION NETWORK CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELVIN BROWN (MENTAL HEALTH/SUBSTANCE ABUSE COUNS)
(850) 264-5745
Entity
Organization
Contact information
Practice address
2551 RIVER FOREST CT, ELLENWOOD, GA 30294-1270
(850) 264-5745
Mailing address
PO BOX 360975, DECATUR, GA 30036-0975
(850) 264-5745
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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