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General NPI Number Information
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NPI Number | 1558809772
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Entity Type | Organization
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Legal Business Name | DEBKAR
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 483 E MAIN ST
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City | CARTERSVILLE
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State | GA
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Zip | 30121-3353
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Country | US
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Telephone | 770-815-7145
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4142
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City | MARIETTA
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State | GA
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Zip | 30061-4142
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Country | US
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Telephone | 770-815-7145
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH MILLS
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Credential | CADC II ICADC
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Telephone | 770-815-7145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 600
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License Number State | GA
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