| Wellspring Life Educational & Counseling Group | |
|
155 Humboldt Dr Fayetteville GA 30214-2026 | |
| (678) 752-1109 | |
| Not Available |
| Full Name | Wellspring Life Educational & Counseling Group |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 155 Humboldt Dr, Fayetteville, Georgia |
| Authorized Official Name and Position | Lakeacha M Jett (CEO) |
| Authorized Official Contact | 4049532590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Life Educational & Counseling Group Po Box 30325 Atlanta GA 30332-1001 Ph: (678) 752-1109 | Wellspring Life Educational & Counseling Group 155 Humboldt Dr Fayetteville GA 30214-2026 Ph: (678) 752-1109 |
| NPI Number | 1386001956 |
|---|---|
| Provider Enumeration Date | 01/27/2016 |
| Last Update Date | 01/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386001956 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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