Kelly's Life Center

NPI #1144521428 in Ellenwood, Georgia

Provider Information

NPI Number: 1144521428
Entity Type: Organization
Organization Name: Kelly's Life Center
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Nov 3, 2010
Last Updated: Nov 3, 2010

Practice Location

Address: 3895 TOLLIVER HILLS DR
City: Ellenwood
State: Georgia
ZIP Code: 30294-1209
Phone: (404) 228-7985

Authorized Official

Name: TERESSA DOUGLAS
Title: OWNER
Phone: (404) 228-7985

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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