Provider Demographics
NPI:1215291042
Name:LIFE MANAGEMENT GROUP
Entity type:Organization
Organization Name:LIFE MANAGEMENT GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-ASEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-733-0333
Mailing Address - Street 1:3540 WHEELER RD
Mailing Address - Street 2:SUITE 619
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1871
Mailing Address - Country:US
Mailing Address - Phone:706-733-0333
Mailing Address - Fax:
Practice Address - Street 1:3540 WHEELER RD
Practice Address - Street 2:SUITE 619
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1871
Practice Address - Country:US
Practice Address - Phone:706-733-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty