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General NPI Number Information
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NPI Number | 1720384084
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Entity Type | Organization
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Legal Business Name | OPEN DOOR CONSULTANTS LLC
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Dates
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Enumeration Date | 02/03/2011
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 2759 DELK RD SE SUITE 1025
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City | MARIETTA
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State | GA
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Zip | 30067-8847
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Country | US
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Telephone | 770-612-0015
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Fax | 770-612-0015
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Provider Business Mailing Address
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Address Line | 2759 DELK RD SE SUITE 1025
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City | MARIETTA
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State | GA
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Zip | 30067-8847
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Country | US
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Telephone | 770-612-0015
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Fax | 770-612-0015
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. PINKEY CARDEN
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Credential | CCADC, R.N.
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Telephone | 770-612-0015
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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 | C0039
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License Number State | GA
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