Provider Demographics
NPI:1073788907
Name:GENERATIONS MARRIAGE AND FAMILY ENRICHMENT CENTER, LLC
Entity Type:Organization
Organization Name:GENERATIONS MARRIAGE AND FAMILY ENRICHMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:DAY
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:478-922-0751
Mailing Address - Street 1:PO BOX 10001
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31095-5001
Mailing Address - Country:US
Mailing Address - Phone:478-922-0751
Mailing Address - Fax:478-922-7059
Practice Address - Street 1:344 CORDER RD
Practice Address - Street 2:SUITE A
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-3643
Practice Address - Country:US
Practice Address - Phone:478-922-0751
Practice Address - Fax:478-922-7059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA726101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty