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General NPI Number Information
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NPI Number | 1164386686
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Entity Type | Organization
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Legal Business Name | DISTINGUISHED JOURNEYS
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 4166 SNAPFINGER WOODS DR
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City | DECATUR
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State | GA
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Zip | 30035-3411
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Country | US
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Telephone | 404-947-8303
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Fax |
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Provider Business Mailing Address
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Address Line | 320 LANIER AVE W STE 200
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7443
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PROGRAM DIRECTOR
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Name | NICOLE R WALTON
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Credential |
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Telephone | 678-527-9699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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