| NPI | 1053978700 |
|---|---|
| Doing Business As | THE LIFE DEVELOPMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | DANIELLE R BONICH Program Director 770-942-4742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2020-01-16 |