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Life Poured Out Services, Inc.
Community/Behavioral Health Agency in Hiram, Georgia
NPI 1174115539

Life Poured Out Services, Inc. is a Community/Behavioral Health Agency based in Hiram, GA. Life Poured Out Services, Inc. practices in Hiram, GA. The NPI Number for Life Poured Out Services, Inc. is 1174115539 and holds a License No. (Georgia).

The current practice location address for Life Poured Out Services, Inc. is 3595 Hiram Douglasville Hwy Ste 108, Hiram, GA and can be reached out via phone at 770-635-7847 and via fax at 910-516-1336. You can also correspond with Life Poured Out Services, Inc. through the mailing address at 3595 HIRAM DOUGLASVILLE HWY STE 108, HIRAM, GA - 30141-4963 (mailing address contact number: 770-635-7847).

Location: 3595 Hiram Douglasville Hwy Ste 108, Hiram, GA, 30141-4963
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1174115539
Provider Name
Life Poured Out Services, Inc.
Credential
Provider Entity Type
Organization
Address
3595 Hiram Douglasville Hwy Ste 108, Hiram, GA, 30141-4963
Phone Number
770-635-7847
Fax Number
910-516-1336
Provider Enumeration Date
02/08/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LPC011523 01 GA PROFESSIONAL
institution
Provider Business Practice Location Address Details
Address
3595 Hiram Douglasville Hwy Ste 108
City
Hiram
State
Georgia
Zip
30141-4963
Phone Number
770-635-7847
Fax Number
910-516-1336
person
Provider Business Mailing Address Details
Address
3595 Hiram Douglasville Hwy Ste 108
City
Hiram
State
Georgia
Zip
30141-4963
Phone Number
770-635-7847
Fax Number
910-516-1336
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
()
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
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