Healthcare Provider Details

I. General information

NPI: 1487197026
Provider Name (Legal Business Name): VERITAS COLLABORATIVE GEORGIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 08/04/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 PERIMETER CENTER EAST SUITE 250
DUNWOODY GA
30346
US

IV. Provider business mailing address

1295 BANDANA BLVD. SUITE 210
ST. PAUL MN
55108
US

V. Phone/Fax

Practice location:
  • Phone: 888-364-5977
  • Fax: 770-545-6284
Mailing address:
  • Phone: 888-364-5977
  • Fax: 919-908-9778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number StateGA

VIII. Authorized Official

Name: MEREDITH TRUDGEON
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 919-767-0274