| Life Changing Missions Llc | |
|
1232 Old Greystone Dr Lithonia GA 30058-2955 | |
| (910) 644-3597 | |
| Not Available |
| Full Name | Life Changing Missions Llc |
|---|---|
| Speciality | Preferred Provider Organization |
| Location | 1232 Old Greystone Dr, Lithonia, Georgia |
| Authorized Official Name and Position | Albert Charles Thompson (OWNER) |
| Authorized Official Contact | 9106443597 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Changing Missions Llc 1232 Old Greystone Dr Lithonia GA 30058-2955 Ph: (910) 644-3597 | Life Changing Missions Llc 1232 Old Greystone Dr Lithonia GA 30058-2955 Ph: (910) 644-3597 |
| NPI Number | 1679194476 |
|---|---|
| Provider Enumeration Date | 05/03/2020 |
| Last Update Date | 05/03/2020 |
| Certification Date | 05/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679194476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 305R00000X | Preferred Provider Organization | (* (Not Available)) | Primary |
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