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General NPI Number Information
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NPI Number | 1508529827
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Entity Type | Organization
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Legal Business Name | ARISE RECOVERY RESIDENCES
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 02/20/2022
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Provider Practice Location Address
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Address Line | 116 PEACHTREE CT STE A
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4800
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Country | US
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Telephone | 770-719-1746
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Fax | 770-719-2368
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Provider Business Mailing Address
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Address Line | 116 PEACHTREE CT STE A
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4800
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Country | US
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Telephone | 678-725-2631
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Fax | 770-719-2368
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Authorized Official
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Title or Position | CEO
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Name | LARRY JENKINS
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Credential | B.S, CAC II, NCAC II
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Telephone | 678-216-6706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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License Number State |
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