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General NPI Number Information
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NPI Number | 1851482376
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Entity Type | Organization
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Legal Business Name | RECOVERY CONSULTANTS OF ATLANTA, INC.
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 1957 LAKESIDE PKWY STE 510
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City | TUCKER
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State | GA
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Zip | 30084-5859
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Country | US
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Telephone | 404-289-0313
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Fax | 404-289-0314
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Provider Business Mailing Address
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Address Line | PO BOX 479
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City | AVONDALE ESTATES
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State | GA
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Zip | 30002-0479
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Country | US
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Telephone | 404-289-0313
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Fax | 404-289-0314
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Authorized Official
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Title or Position | CEO
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Name | MS. CASSANDRA COLLINS
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Credential | LCSW
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Telephone | 404-289-0313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 11D1020819
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | GA
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