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General NPI Number Information
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NPI Number | 1336527902
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Entity Type | Organization
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Legal Business Name | WRIGHTWAY TRANSFORMSLIVES, LLC
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 6740 JAMES B RIVERS DR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-2235
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Country | US
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Telephone | 470-545-9267
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Fax |
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Provider Business Mailing Address
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Address Line | 6740 JAMES B RIVERS DR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-2235
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Country | US
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Telephone | 470-545-9267
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | MRS. ARTHURINE L WRIGHT
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Credential | LPC
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Telephone | 470-545-9267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LPC005913
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License Number State | GA
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