Healthcare Provider Details

I. General information

NPI: 1225984511
Provider Name (Legal Business Name): MOSAIC WELLNESS AND RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12050 FINDLEY RD
JOHNS CREEK GA
30097-1483
US

IV. Provider business mailing address

12050 FINDLEY RD
JOHNS CREEK GA
30097-1483
US

V. Phone/Fax

Practice location:
  • Phone: 404-383-1129
  • Fax:
Mailing address:
  • Phone: 404-383-1129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TODD STUMBO
Title or Position: OWNER
Credential:
Phone: 678-472-5994