MEDICARE: THOROUGHBRED WELLNESS AND RECOVERY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1093666745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOROUGHBRED WELLNESS AND RECOVERY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1293
Second Line	:
City	:	HOLLY SPRINGS
State	:	GA
Zip	:	30142-1293
Country	:	US
Telephone Number	:	770-564-4856
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 JOHNSON FERRY RD STE 225
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8177
Country	:	US
Telephone Number	:	770-564-4856
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TODD STUMBO
Credential	:
Telephone Number	:	678-472-5994

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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