Healthcare Provider Details

I. General information

NPI: 1205949641
Provider Name (Legal Business Name): OUR COMMON WELFARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3423 COVINGTON DR SUITE B
DECATUR GA
30032-1846
US

IV. Provider business mailing address

3423 COVINGTON DR SUITE B
DECATUR GA
30032-1846
US

V. Phone/Fax

Practice location:
  • Phone: 404-284-6061
  • Fax: 404-284-9810
Mailing address:
  • Phone: 404-284-6061
  • Fax: 404-284-9810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. PATRICIA BROWN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 404-284-6061