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General NPI Number Information
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NPI Number | 1740974443
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Entity Type | Organization
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Legal Business Name | SANATIVE RECOVERY AND WELLNESS GA LLC
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 1000 HOLCOMB WOODS PKWY STE 112
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City | ROSWELL
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State | GA
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Zip | 30076-2588
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Country | US
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Telephone | 943-777-3250
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Fax |
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Provider Business Mailing Address
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Address Line | 1195 N MAPLE AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08755-1321
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | STEPHEN ENGEL
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Credential |
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Telephone | 732-285-4800
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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 |
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License Number State |
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