Healthcare Provider Details

I. General information

NPI: 1003953548
Provider Name (Legal Business Name): ALLIANCE RECOVERY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 E PONCE DE LEON AVE
DECATUR GA
30030-2711
US

IV. Provider business mailing address

1116 E PONCE DE LEON AVE
DECATUR GA
30030-2711
US

V. Phone/Fax

Practice location:
  • Phone: 404-377-7669
  • Fax: 404-377-8536
Mailing address:
  • Phone: 404-377-7669
  • Fax: 404-377-8536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberNTP001000
License Number StateGA

VIII. Authorized Official

Name: ASHLEY PREYER
Title or Position: BILLING MANAGER
Credential:
Phone: 470-781-6242