Provider Demographics
NPI:1427654144
Name:GARONE R ENTERPRISES LLC LIFE SPRING COUNSELING CENTER
Entity type:Organization
Organization Name:GARONE R ENTERPRISES LLC LIFE SPRING COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GARONE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-915-1276
Mailing Address - Street 1:344 MOUNT ALTO RD SW # 9151276
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-4148
Mailing Address - Country:US
Mailing Address - Phone:404-915-1276
Mailing Address - Fax:
Practice Address - Street 1:504 RIVERSIDE PKWY NE STE 114
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-2981
Practice Address - Country:US
Practice Address - Phone:404-915-1276
Practice Address - Fax:706-995-6848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty