| Life Link Of Louisiana | |
|
608 Stonecrest Drive Loganville GA 30052 | |
| (678) 949-3184 | |
| Not Available |
| Full Name | Life Link Of Louisiana |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 608 Stonecrest Drive, Loganville, Georgia |
| Authorized Official Name and Position | Carlos Porter (OWNER) |
| Authorized Official Contact | 6789493184 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Link Of Louisiana 608 Stonecrest Drive Loganville GA 30052 Ph: (678) 949-3184 | Life Link Of Louisiana 608 Stonecrest Drive Loganville GA 30052 Ph: (678) 949-3184 |
| NPI Number | 1295158699 |
|---|---|
| Provider Enumeration Date | 01/22/2014 |
| Last Update Date | 01/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295158699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | GA006581 (Georgia) | Primary |
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