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General NPI Number Information
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NPI Number | 1073408134
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Entity Type | Organization
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Legal Business Name | PEACHTREE BEHAVIORAL LLC
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 2255 CUMBERLAND PKWY SE BLDG 1600
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City | ATLANTA
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State | GA
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Zip | 30339-4515
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Country | US
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Telephone | 943-216-3882
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Fax |
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Provider Business Mailing Address
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Address Line | 2255 CUMBERLAND PKWY SE BLDG 1600
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City | ATLANTA
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State | GA
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Zip | 30339-4515
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Country | US
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Telephone | 943-216-3882
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT L SMITH
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Credential |
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Telephone | 943-216-3882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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