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General NPI Number Information
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NPI Number | 1871087981
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Entity Type | Organization
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Legal Business Name | WESTLOND RECOVERY AND HOLISTIC COUNSELING CENTER
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1226 MARKS CHURCH ROAD SUITE F
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City | MARTINEZ
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State | GA
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Zip | 30909-1862
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Country | US
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Telephone | 404-769-8771
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Fax |
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Provider Business Mailing Address
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Address Line | 4115 COLUMBIA RD STE 183
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City | MARTINEZ
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State | GA
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Zip | 30907-0405
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Country | US
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Telephone | 678-435-9135
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KECIS WEST
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Credential |
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Telephone | 404-769-8771
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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 |
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License Number State |
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