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General NPI Number Information
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NPI Number | 1164788139
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Entity Type | Organization
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Legal Business Name | THE ROAD TO RECOVERY, INC
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 04/04/2012
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Provider Practice Location Address
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Address Line | 3155 PRESIDENTIAL DR SUITE 104
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City | ATLANTA
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State | GA
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Zip | 30340-3924
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Country | US
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Telephone | 770-220-2885
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Fax | 678-990-1496
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Provider Business Mailing Address
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Address Line | 3155 PRESIDENTIAL DR SUITE 104
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City | ATLANTA
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State | GA
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Zip | 30340-3924
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Country | US
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Telephone | 770-220-2885
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Fax | 678-990-1496
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | ROCIO WOODY
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Credential | MSW, MAC
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Telephone | 770-220-2885
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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 | 0326829
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License Number State | GA
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