Healthcare Provider Details

I. General information

NPI: 1851482376
Provider Name (Legal Business Name): RECOVERY CONSULTANTS OF ATLANTA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1957 LAKESIDE PKWY STE 510
TUCKER GA
30084-5859
US

IV. Provider business mailing address

PO BOX 479
AVONDALE ESTATES GA
30002-0479
US

V. Phone/Fax

Practice location:
  • Phone: 404-289-0313
  • Fax: 404-289-0314
Mailing address:
  • Phone: 404-289-0313
  • Fax: 404-289-0314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number11D1020819
License Number StateGA

VIII. Authorized Official

Name: MS. CASSANDRA COLLINS
Title or Position: CEO
Credential: LCSW
Phone: 404-289-0313