MISTER LIFE COACH (NPI# 1619403219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619403219 |
| Entity Type | Organization |
| Organization Name | MISTER LIFE COACH |
| Practice Address |
3681 N Decatur Rd Apt R11 Decatur GA 30032-1062 |
| Mailing Address |
Po Box 283 Rex GA 30273-0283 |
| Practice Telephone | 6315537131 |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |
| Authorized Official Name | MR. ROBERT GREEN JR. (LIFE COACH) |
| Authorized Official Telephone | 6315537131 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508391756 | Mister Life Coach | Community Based Residential Treatment Facility, Mental Illness | 3681 N Decatur Rd Apt R11, Decatur, GA 30032-1062 | 2017-04-25 |
| Street Address |
3681 N DECATUR RD APT R11 |
| City | DECATUR |
| State | GA |
| Zip Code | 30032-1062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508391756 | Mister Life Coach | Community Based Residential Treatment Facility, Mental Illness | 3681 N Decatur Rd Apt R11, Decatur, GA 30032-1062 | 2017-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861028078 | Anchor Home Healthcare Services, Inc. | Community/Behavioral Health | 3717 Elkridge Drive, Decatur, GA 30032 | 2020-03-19 |
| 1578959201 | Trusted Nurses | Nursing Care | 1959 Barberrie Ln, Decatur, GA 30032 | 2015-04-09 |
| 1225436751 | God's Helper's Private Home Care, LLC | In Home Supportive Care | 1916 Willa Dr, Decatur, GA 30032 | 2014-12-16 |
| 1366878712 | Teresa A Johnson | Counselor | 1585 Cobbs Creek Lane, Decatur, GA 30032 | 2013-09-17 |
| 1629213590 | Curlen L Baird-scott | Registered Nurse | Child and Adolescent Stabilization Unit, 2591 Candler Road, Decatur, GA 30032 | 2008-12-08 |
| 1659527919 | Louis Aaron Calderon | Psychiatry & Neurology | 3408 Covington Highway, Georgia Department of Juvenile Justice, Decatur, GA 30032 | 2008-08-18 |
| 1932387982 | Turning Point Behavioral Health and Wellness Center | Community/Behavioral Health | 4292 Memorial Drive Suite C, Decatur, GA 30032 | 2008-02-01 |
| 1528190865 | Jennifer Weeks Kaufman | Speech-Language Pathologist | 1441 Clifton Road Ne, Atlanta, GA 30032 | 2007-03-12 |
| 1093847147 | Mary Sprague | Speech-Language Pathologist | 1441 Clifton Road North East, Atlanta, GA 30032 | 2007-03-12 |
| 1356479976 | Julie Witten | Speech-Language Pathologist | 1441 Clifton Road, N.e., Atlanta, GA 30032 | 2007-03-02 |
| Find all providers in zip 30032 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114275435 | Webster-cantrell Hall | Residential Treatment Facility, Emotionally Disturbed Children | 1220 Underwood Ct, Decatur, IL 62526-1983 | 2012-08-16 |
| 1518238955 | Webster-cantrell Hall | Residential Treatment Facility, Emotionally Disturbed Children | 2749 N Norwood Ave, Decatur, IL 62526-1517 | 2012-01-17 |
| 1689633828 | Webster-cantrell Hall | Residential Treatment Facility, Emotionally Disturbed Children | 1942 E Cantrell St, Decatur, IL 62521-3214 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023543766 | One Heart and One Mind Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5737 Old National Hwy, Suite 300, Atlanta, GA 30349-7410 | 2017-05-01 |
| 1396131249 | There's No Place Like A Loving Home LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2000 Jardin Ct, Alpharetta, GA 30022-4600 | 2015-04-07 |
| 1912343302 | Our Spot | Residential Treatment Facility, Emotionally Disturbed Children | 1015 E Inman St, Statesboro, GA 30458-2049 | 2013-05-13 |
| 1902163520 | Shepherd's Hill Academy, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2200 Price Rd, Martin, GA 30557-3457 | 2012-04-20 |
| 1871879312 | Vision Youth Services Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4228 Redan Rd, Stone Mountain, GA 30083-5040 | 2011-10-28 |
| 1356634034 | Soaring Eagle Children's Group | Residential Treatment Facility, Emotionally Disturbed Children | 3183 Northbrook Dr, Atlanta, GA 30341-4629 | 2011-05-27 |
| 1124330386 | Favorable Network Solutions | Residential Treatment Facility, Emotionally Disturbed Children | 881 Memorial Dr Se, Suite 213, Atlanta, GA 30316-1270 | 2010-07-04 |
| 1467687665 | Positive Impact Hhs, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 934 Garden Walk Blvd. # 903, College Park, GA 30349-8508 | 2009-05-18 |
| 1932342235 | The Sanctuary House, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 500 John Deere Rd Nw, Monroe, GA 30656-4769 | 2009-04-16 |
| 1417198458 | Naciema Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 3200 Stone Rd Sw Apt W8, Atlanta, GA 30331-2920 | 2009-03-22 |
| Find all providers with the same taxonomy | ||||
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| 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.