Basic Information
| Provider Information | |||||||||
| NPI: | 1538607346 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GEORGIA DETOX AND RECOVERY CENTERS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 WINDY RIDGE PKWY SE | ||||||||
| Address2: | STE # 210-S | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303395665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788130505 | ||||||||
| FaxNumber: | 6788130505 | ||||||||
| Practice Location | |||||||||
| Address1: | 2300 WINDY RIDGE PKWY SE | ||||||||
| Address2: | STE # 210-S | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303395665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788130505 | ||||||||
| FaxNumber: | 6788130505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | TOWNSEND | ||||||||
| AuthorizedOfficialFirstName: | DEBRA | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP OF RCM | ||||||||
| AuthorizedOfficialTelephone: | 4704401647 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.