Provider Demographics
NPI:1922686682
Name:CENTERED FOR LIFE, INC
Entity Type:Organization
Organization Name:CENTERED FOR LIFE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:912-268-4488
Mailing Address - Street 1:2487 DEMERE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-5644
Mailing Address - Country:US
Mailing Address - Phone:912-268-4488
Mailing Address - Fax:
Practice Address - Street 1:2487 DEMERE RD STE 500
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-5644
Practice Address - Country:US
Practice Address - Phone:912-268-4488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1316051030OtherNPI
GA1538448402OtherNPI