NNK 4 LIVING INDEPENDENTLY FOR EXCELLENCE (L.I.F.E.) (NPI# 1588178487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588178487 |
| Entity Type | Organization |
| Organization Name | NNK 4 LIVING INDEPENDENTLY FOR EXCELLENCE (L.I.F.E.) |
| Other Organization Name | NNK 4 L.I.F.E. |
| Practice Address |
3030 Edwards Dr Se Ste A Conyers GA 30013-1856 |
| Mailing Address |
Po Box 741125 Riverdale GA 30274-1300 |
| Practice Telephone | 6785613091 |
| Mailing Telephone | 4044383677 |
| Mailing Fax Number | 4047958974 |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | NICOLE N BENTON (CEO/OWNER) |
| Authorized Official Telephone | 6785613091 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
8941 | GA | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
8941 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003181947A | 05 |
| Other Name | Type Code |
|---|---|
| NNK 4 L.I.F.E. | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5555 Glenridge Connector Ste 200, Sandy Springs, GA 303424740 | 6785613091 | 4047958974 |
| 640 Georgia 138, Riverdale, GA 302743027 | 6785613091 | |
| 585 Old Norcross Rd Ste K, Lawrenceville, GA 300468702 | 6785613091 |
| Street Address |
3030 EDWARDS DR SE STE A |
| City | CONYERS |
| State | GA |
| Zip Code | 30013-1856 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842295 | Fit Therapy, LLC | Physical Therapist | 2008 Eastview Parkway, Suite 150, Conyers, GA 30013 | 2020-05-12 |
| 1144854753 | Atl Optical LLC | Optometrist | 1285 Ga 138, Conyers, GA 30013 | 2020-02-24 |
| 1386201820 | Achundris P Taylor | Social Worker | Harvest Grove Lane, Conyers, GA 30013 | 2019-05-21 |
| 1588153381 | Curbside Medical Transporters | Ambulance | 2404 Brynlyn Woods Dr Ne, Conyers, GA 30013 | 2018-05-07 |
| 1184124877 | Nursing Companion, LLC | Homemaker | 1064 Duke Dr, Conyers, GA 30013 | 2018-02-19 |
| 1588163638 | Atlanta Plus Urgent Care | Clinic/Center | 2121 Salem Rd. Se, Conyers, GA 30013 | 2018-02-05 |
| 1043735244 | Niki Tanyell Davis | Licensed Practical Nurse | 1403 Windy Hill Court, Conyers, GA 30013 | 2017-08-08 |
| 1063941490 | Comprehensive Health and Rehab LLC | Clinic/Center | 2500 Riverton Drive, Conyers, GA 30013 | 2017-06-08 |
| 1306373188 | Graceol Corporation | Family Medicine | 1035 Honey Creek Rd, Conyers, GA 30013 | 2017-05-11 |
| 1881149268 | Jsa Dental Associates Conyers PC | Dentist | 1151 Nor Tec Dr, Suite B, Conyers, GA 30013 | 2016-08-16 |
| Find all providers in zip 30013 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1093326217 | Shaunda Ayana Jones | Counselor | 2124 Blueberry Ln, Conyers, GA 30013-1476 | 2020-08-11 |
| 1508484627 | Star-jabrea Farrington | Counselor | 323 Saint Clair Dr, Conyers, GA 30094-4968 | 2020-07-07 |
| 1588138911 | Candice Waller | Counselor | 2856 Bridle Creek Dr Sw, Conyers, GA 30094-5677 | 2019-01-18 |
| 1336636133 | Friends In Transformation LLC | Counselor | 2031 Gees Mill Rd Ne Ste 102, Conyers, GA 30013-1328 | 2018-04-17 |
| 1457853160 | Charonda Gardner | Counselor | 3205 Salem Rd Se, Conyers, GA 30013-5302 | 2018-03-08 |
| 1083124762 | Graceol Counseling Center Inc | Counselor | 1035 Honey Creek Rd Se, Conyers, GA 30013-2948 | 2017-10-06 |
| 1356851547 | Melissa Morgan | Counselor | 532 Saint Clair Dr, Conyers, GA 30094-4972 | 2017-10-03 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1225570062 | Lakesha Link | Counselor | 1936 Iris Dr Sw, Conyers, GA 30094-1245 | 2016-11-10 |
| Find all providers in CONYERS | ||||
Please comment or provide details below to improve the information on NNK 4 LIVING INDEPENDENTLY FOR EXCELLENCE (L.I.F.E.).
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.