Provider Demographics
NPI:1538607346
Name:GEORGIA DETOX AND RECOVERY CENTERS, LLC
Entity type:Organization
Organization Name:GEORGIA DETOX AND RECOVERY CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF RCM
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-440-1647
Mailing Address - Street 1:2300 WINDY RIDGE PKWY SE
Mailing Address - Street 2:STE # 210-S
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5665
Mailing Address - Country:US
Mailing Address - Phone:678-813-0505
Mailing Address - Fax:678-813-0505
Practice Address - Street 1:2300 WINDY RIDGE PKWY SE
Practice Address - Street 2:STE # 210-S
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5665
Practice Address - Country:US
Practice Address - Phone:678-813-0505
Practice Address - Fax:678-813-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility