Organization
LIFE BEYOND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELYN ANN SUBLETT (CEO)
(678) 705-7636
Entity
Organization
Contact information
Practice address
435 BURDETT RIDGE CT, COLLEGE PARK, GA 30349-3785
(678) 705-7636
Mailing address
435 BURDETT RIDGE CT, COLLEGE PARK, GA 30349-3785
(678) 705-7636
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/08/2011
Last updated
04/08/2011
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