Healthcare Provider Details

I. General information

NPI: 1962103788
Provider Name (Legal Business Name): AWARE RECOVERY CARE OF GEORGIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 THE EXCHANGE SE STE 610
ATLANTA GA
30339-2051
US

IV. Provider business mailing address

35 THORPE AVE STE 104
WALLINGFORD CT
06492-1948
US

V. Phone/Fax

Practice location:
  • Phone: 770-526-0535
  • Fax:
Mailing address:
  • Phone: 203-640-0091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: GEORGE MERHI
Title or Position: CFO
Credential:
Phone: 203-799-5799