Healthcare Provider Details

I. General information

NPI: 1235060070
Provider Name (Legal Business Name): INTENTIONAL LIVING STRATEGIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 ROBINSON WOOD DR
RIVERDALE GA
30296-1679
US

IV. Provider business mailing address

2900 ROBINSON WOOD DR
RIVERDALE GA
30296-1679
US

V. Phone/Fax

Practice location:
  • Phone: 678-400-4777
  • Fax:
Mailing address:
  • Phone: 678-400-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHINA D ALLEN
Title or Position: CEO/CFO
Credential: PHD, LPC, NCC. CHT.
Phone: 678-400-4777