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General NPI Number Information
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NPI Number | 1427654144
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Entity Type | Organization
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Legal Business Name | GARONE R ENTERPRISES LLC LIFE SPRING COUNSELING CENTER
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 504 RIVERSIDE PKWY NE STE 114
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City | ROME
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State | GA
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Zip | 30161-2981
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Country | US
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Telephone | 404-915-1276
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Fax | 706-995-6848
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Provider Business Mailing Address
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Address Line | 344 MOUNT ALTO RD SW # 9151276
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City | ROME
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State | GA
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Zip | 30165-4148
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Country | US
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Telephone | 404-915-1276
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ROSEMARY J GARONE
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Credential | LPC
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Telephone | 404-915-1276
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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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