Organization
STRAIGHT STREET LIFE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA L FRAZIER BA, CERTIFIED LIFE C (EXECUTIVE DIRECTOR)
(404) 951-3969
Entity
Organization
Contact information
Practice address
12461 VETERANS MEMORIAL, DOUGLASVILLE, GA 30134
(770) 225-4701
Mailing address
12461 VETERANS MEMORIAL, DOUGLASVILLE, GA 30134
(770) 225-4701
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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