Healthcare Provider Details

I. General information

NPI: 1265607683
Provider Name (Legal Business Name): ASSERTIVE COMMUNITY RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2008
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2568 PARK CENTRAL BLVD
DECATUR GA
30035-3916
US

IV. Provider business mailing address

2568 PARK CENTRAL BLVD
DECATUR GA
30035-3916
US

V. Phone/Fax

Practice location:
  • Phone: 404-508-0078
  • Fax: 404-508-0071
Mailing address:
  • Phone: 404-508-0078
  • Fax: 404-508-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number044-215-D
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FRANK S MCALLISTER
Title or Position: CEO
Credential:
Phone: 404-508-0078