Healthcare Provider Details

I. General information

NPI: 1922941012
Provider Name (Legal Business Name): BETT-R.LIFE & ASSOCIATES, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8317 OFFICE PARK DR
DOUGLASVILLE GA
30134-6936
US

IV. Provider business mailing address

8317 OFFICE PARK DR
DOUGLASVILLE GA
30134-6936
US

V. Phone/Fax

Practice location:
  • Phone: 855-252-7878
  • Fax: 888-428-1397
Mailing address:
  • Phone: 855-252-7878
  • Fax: 888-428-1397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. KEBA JANINE RICHMOND GREEN
Title or Position: OWNER
Credential: LPC
Phone: 855-252-7878