Provider Demographics
NPI:1841659604
Name:LIFE EMPOWERMENT SERVICES
Entity type:Organization
Organization Name:LIFE EMPOWERMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:DONIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:678-304-8215
Mailing Address - Street 1:1755 THE EXCHANGE SE
Mailing Address - Street 2:STE 205
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-7400
Mailing Address - Country:US
Mailing Address - Phone:678-304-8215
Mailing Address - Fax:
Practice Address - Street 1:3595 CANTON RD
Practice Address - Street 2:A9-320
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-2658
Practice Address - Country:US
Practice Address - Phone:678-304-8215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency