OrganizationActive
Integrated Life Center, Inc.
NPI 1427199199 · Mental Illness Community Based Residential Treatment Facility · Stone Mountain, GA
Provider details
- NPI number
- 1427199199
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Dennis O'Brien, Ceo(404) 377-5556
- License
- 025893 (GA)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4641 Stonegate Industrial Blvd
Stone Mountain, GA 30083-1908
Phone: (404) 377-5556
Fax: (404) 292-9903
Street-level locationGet directions
Mailing address
4641 Stonegate Industrial Blvd
Stone Mountain, GA 30083-1908
Registry dates
- Enumerated
- 2007-02-08
- Last updated
- 2011-11-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.