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General NPI Number Information
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NPI Number | 1275765307
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Entity Type | Organization
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Legal Business Name | TALBOTT RECOVERY CAMPUS
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 4480 N SHALLOWFORD RD STE 224
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City | DUNWOODY
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State | GA
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Zip | 30338-6410
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Country | US
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Telephone | 404-952-2500
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Fax | 770-454-5575
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Provider Business Mailing Address
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Address Line | 4480 N SHALLOWFORD RD STE 224
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City | DUNWOODY
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State | GA
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Zip | 30338-6410
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Country | US
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Telephone | 404-952-2500
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Fax | 770-454-5575
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Authorized Official
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Title or Position | SR VP CFO
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Name | STEVE FILTON
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Credential |
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Telephone | 610-768-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | DRUG12459
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License Number State | GA
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