| Rebuilding Lives Counseling And Consulting Llc | |
|
4411 Suwanee Dam Rd Suite 635 Suwanee GA 30024-8701 | |
| (678) 835-8144 | |
| Not Available |
| Full Name | Rebuilding Lives Counseling And Consulting Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4411 Suwanee Dam Rd, Suwanee, Georgia |
| Authorized Official Name and Position | Nedra Tamara Penland (CO- FOUNDER) |
| Authorized Official Contact | 6788358144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rebuilding Lives Counseling And Consulting Llc Post Office Box 465873 35 Patterson Rd. Lawrenceville GA 30042 Ph: (678) 835-8144 | Rebuilding Lives Counseling And Consulting Llc 4411 Suwanee Dam Rd Suite 635 Suwanee GA 30024-8701 Ph: (678) 835-8144 |
| NPI Number | 1215288097 |
|---|---|
| Provider Enumeration Date | 09/20/2012 |
| Last Update Date | 12/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215288097 | NPI | - | NPPES |
| 006862116A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 005762 (Georgia) | Primary |
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