Provider Demographics
NPI:1417408519
Name:GEORGIA LIFE LINKS
Entity Type:Organization
Organization Name:GEORGIA LIFE LINKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARION
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:REESE-THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-755-3197
Mailing Address - Street 1:1544 VENETIAN DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-3550
Mailing Address - Country:US
Mailing Address - Phone:404-755-3197
Mailing Address - Fax:
Practice Address - Street 1:1544 VENETIAN DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-3550
Practice Address - Country:US
Practice Address - Phone:404-755-3197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA014100LGB311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home