Healthcare Provider Details

I. General information

NPI: 1174925671
Provider Name (Legal Business Name): MARRIAGE HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 S MAIN ST STE 100
ALPHARETTA GA
30009-7918
US

IV. Provider business mailing address

294 S MAIN ST STE 100
ALPHARETTA GA
30009-7918
US

V. Phone/Fax

Practice location:
  • Phone: 678-566-0403
  • Fax: 678-566-1422
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number553
License Number StateGA

VIII. Authorized Official

Name: JAMES EDWARD EPPERLY
Title or Position: PRESIDENT
Credential: D.MIN
Phone: 678-566-0403