Healthcare Provider Details

I. General information

NPI: 1013692177
Provider Name (Legal Business Name): NJOY LIFE LIVING IN FULL EMPOWERMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 PEACHTREE RD NE STE 145-609
ATLANTA GA
30326-1085
US

IV. Provider business mailing address

3343 PEACHTREE RD NE STE 145-609
ATLANTA GA
30326-1085
US

V. Phone/Fax

Practice location:
  • Phone: 678-820-6569
  • Fax: 414-296-8877
Mailing address:
  • Phone: 678-820-6569
  • Fax: 414-296-8877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NINA JOY MENA
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 678-820-6569