Provider Demographics
NPI:1306321476
Name:BETTER HEALTH GREATER LIFE LLC
Entity type:Organization
Organization Name:BETTER HEALTH GREATER LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LESA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CREWS
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:404-835-7779
Mailing Address - Street 1:5040 CLUB VISTA PT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-3772
Mailing Address - Country:US
Mailing Address - Phone:404-835-7779
Mailing Address - Fax:
Practice Address - Street 1:494 BOULEVARD SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-3426
Practice Address - Country:US
Practice Address - Phone:404-835-7779
Practice Address - Fax:678-701-9903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty