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General NPI Number Information
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NPI Number | 1255743837
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Entity Type | Organization
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Legal Business Name | ANGELS RECOVERY
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 05/29/2014
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Provider Practice Location Address
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Address Line | 6755 PEACHTREE INDUSTRIAL BLVD 110
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City | ATLANTA
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State | GA
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Zip | 30360-2223
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Country | US
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Telephone | 404-312-6531
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 INDEPENDENCE WAY
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City | NORCROSS
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State | GA
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Zip | 30093-6810
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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 | DIRECTOR
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Name | ELIZABETH TOLEDO
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Credential |
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Telephone | 404-312-6531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CSW004248
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License Number State | GA
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