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General NPI Number Information
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NPI Number | 1891214375
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Entity Type | Organization
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Legal Business Name | CENTERED RECOVERY PROGRAMS, LLC
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 11111 HOUZE RD STE 101
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City | ROSWELL
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State | GA
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Zip | 30076-1464
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Country | US
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Telephone | 770-410-4894
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Fax |
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Provider Business Mailing Address
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Address Line | 11111 HOUZE RD STE 101
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City | ROSWELL
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State | GA
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Zip | 30076-1464
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Country | US
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Telephone | 770-410-4894
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Fax | 770-410-4897
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | KRISTA SMITH
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Credential |
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Telephone | 770-410-4894
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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 | 060-468-D
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License Number State | GA
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