| Lmt Enterprises, Llc | |
|
5238 Ashley Dr Sw Lilburn GA 30047-6639 | |
| (770) 356-0101 | |
| Not Available |
| Full Name | Lmt Enterprises, Llc |
|---|---|
| Speciality | Counselor |
| Location | 5238 Ashley Dr Sw, Lilburn, Georgia |
| Authorized Official Name and Position | Lisa M Tait (MANAGING PARTNER) |
| Authorized Official Contact | 7703560101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lmt Enterprises, Llc 5238 Ashley Dr Sw Lilburn GA 30047-6639 Ph: (770) 356-0101 | Lmt Enterprises, Llc 5238 Ashley Dr Sw Lilburn GA 30047-6639 Ph: (770) 356-0101 |
| NPI Number | 1467883314 |
|---|---|
| Provider Enumeration Date | 12/03/2013 |
| Last Update Date | 12/01/2014 |
| Medicare PECOS PAC ID | 8325484801 |
|---|---|
| Medicare Enrollment ID | O20240306003084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467883314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 007320 (Georgia) | Primary |
| Provider Name | Lisa Monette Tait |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083954192 PECOS PAC ID: 9234575713 Enrollment ID: I20240306003177 |
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