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General NPI Number Information
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NPI Number | 1043884927
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Entity Type | Organization
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Legal Business Name | CENTER FOR WELLNESS AND RECOVERY OF NORTHEAST GA CORPORATION
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 467 W DOYLE ST
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City | TOCCOA
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State | GA
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Zip | 30577-1791
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Country | US
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Telephone | 706-886-4673
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Fax | 706-381-3100
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Provider Business Mailing Address
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Address Line | 467 W DOYLE ST
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City | TOCCOA
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State | GA
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Zip | 30577-1791
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Country | US
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Telephone | 706-886-4673
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Fax | 706-381-3100
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Authorized Official
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Title or Position | CFO
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Name | KATHY WHITMIRE
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Credential |
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Telephone | 706-886-4673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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