Healthcare Provider Details

I. General information

NPI: 1972601193
Provider Name (Legal Business Name): GALAX TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 PAINTER ST
GALAX VA
24333-3828
US

IV. Provider business mailing address

6100 TOWER CIR STE 1000
FRANKLIN TN
37067-1509
US

V. Phone/Fax

Practice location:
  • Phone: 276-236-2994
  • Fax: 276-236-4802
Mailing address:
  • Phone: 615-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number617-06-001
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number617-01-025
License Number StateVA

VIII. Authorized Official

Name: BRIAN P FARLEY
Title or Position: VP & SECRETARY
Credential:
Phone: 615-861-6000