Life Poured Out Services, Inc.
LBN: Life Poured Out Services, Inc.
Life Poured Out Services, Inc. is an health care organization with primary practice located at 3595 Hiram Douglasville Hwy Ste 108 , Hiram GA 30141-4963. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Agencies / Community/Behavioral Health. Agencies / Community/Behavioral Health is the primary health care specialty.
Life Poured Out Services, Inc. can be contacted via phone (770) 635-7847, or through Blount, Suzett Delicia via phone (718) 644-4998.
Contact Information
Primary practice address
3595 Hiram Douglasville Hwy Ste 108
Hiram GA 30141-4963
Phone: (770) 635-7847
Fax: (910) 516-1336
Website:
Authorized official contact:
Name: Blount, Suzett Delicia Licensed Professional Counselor (LPC)
Phone: (718) 644-4998
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | ||
| Agencies / Community/Behavioral Health | 251S00000X |
Profile Details
| NPI number | 1174115539 |
|---|---|
| LBN Legal business name | Life Poured Out Services, Inc. |
| DBA Doing business as | Life Poured Out Services, Inc. |
| Authorized official | Blount, Suzett Delicia Licensed Professional Counselor (LPC) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 8th, 2021 |
| Last updated | Dec 8th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174115539 | NPPES |
| Georgia | Other | LPC011523 | PROFESSIONAL |
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