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General NPI Number Information
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NPI Number | 1619575834
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Entity Type | Organization
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Legal Business Name | THE IV SPOT, LLC.
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Dates
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Enumeration Date | 10/09/2020
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 2799 LAWRENCEVILLE HWY STE 107
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City | DECATUR
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State | GA
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Zip | 30033-2517
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Country | US
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Telephone | 678-739-1879
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Fax |
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Provider Business Mailing Address
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Address Line | 2799 LAWRENCEVILLE HWY STE 107
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City | DECATUR
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State | GA
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Zip | 30033-2517
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Country | US
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Telephone | 678-739-1879
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAMIE BOWMAN
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Credential |
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Telephone | 678-739-1879
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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