Life Intervention Network Center

NPI #1588059232 in Ellenwood, Georgia

Provider Information

NPI Number: 1588059232
Entity Type: Organization
Organization Name: Life Intervention Network Center
Primary Specialty: Counselor - Mental Health
Enumeration Date: Mar 31, 2015
Last Updated: Mar 31, 2015

Practice Location

Address: 2551 RIVER FOREST CT
City: Ellenwood
State: Georgia
ZIP Code: 30294-1270
Phone: (850) 264-5745

Authorized Official

Name: MR. KELVIN BROWN
Title: MENTAL HEALTH/SUBSTANCE ABUSE COUNS
Phone: (850) 264-5745

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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