Healthcare Provider Details

I. General information

NPI: 1093666745
Provider Name (Legal Business Name): THOROUGHBRED WELLNESS AND RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 JOHNSON FERRY RD STE 225
MARIETTA GA
30062-8177
US

IV. Provider business mailing address

PO BOX 1293
HOLLY SPRINGS GA
30142-1293
US

V. Phone/Fax

Practice location:
  • Phone: 770-564-4856
  • Fax:
Mailing address:
  • Phone: 770-564-4856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TODD STUMBO
Title or Position: CEO
Credential:
Phone: 678-472-5994