| Informed Group Enterprises | |
|
4737 S Seminole Dr Douglasville GA 30135-4641 | |
| (770) 298-5094 | |
| Not Available |
| Full Name | Informed Group Enterprises |
|---|---|
| Speciality | Counselor |
| Location | 4737 S Seminole Dr, Douglasville, Georgia |
| Authorized Official Name and Position | Lyle Coalwell (COUNSELOR) |
| Authorized Official Contact | 7702985094 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Informed Group Enterprises 4737 S Seminole Dr Douglasville GA 30135-4641 Ph: (770) 298-5094 | Informed Group Enterprises 4737 S Seminole Dr Douglasville GA 30135-4641 Ph: (770) 298-5094 |
| NPI Number | 1639425150 |
|---|---|
| Provider Enumeration Date | 08/02/2012 |
| Last Update Date | 08/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639425150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | LPC002580 (Georgia) | Primary |
| 174400000X | Specialist | (* (Not Available)) | Secondary |
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