Provider Demographics
NPI:1063394856
Name:MIRRORS OF THE HEART INDEPENDENT LIVING SERVICES
Entity type:Organization
Organization Name:MIRRORS OF THE HEART INDEPENDENT LIVING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIVIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:669-226-0381
Mailing Address - Street 1:4316 RIVERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-2929
Mailing Address - Country:US
Mailing Address - Phone:669-226-0381
Mailing Address - Fax:559-408-5589
Practice Address - Street 1:4316 RIVERWOOD CIR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-2929
Practice Address - Country:US
Practice Address - Phone:669-226-0381
Practice Address - Fax:559-408-5589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty