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General NPI Number Information
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NPI Number | 1356487714
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Entity Type | Organization
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Legal Business Name | THE LIFE'S STAR PROJECT INC.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 575 BOULEVARD SE SUITE 200
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City | ATLANTA
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State | GA
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Zip | 30312-3464
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Country | US
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Telephone | 404-624-4346
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Fax |
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Provider Business Mailing Address
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Address Line | 280 COBB PKWY S SUITE 183
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City | MARIETTA
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State | GA
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Zip | 30060-6501
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Country | US
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Telephone | 404-624-4346
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Fax | 770-432-7034
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ANGELA D JONES
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Credential | MS.ED
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Telephone | 404-624-4346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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