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NPI Code Detail

MEDICARE: GALAX TREATMENT CENTER, LLC

MEDICARE: GALAX TREATMENT CENTER, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1261QM2800XMethadone Clinic617-06-001VA

General Provider Information

NPI Number : 1386783314
Entity Type Code : Organization
Provider Name (Legal Business Name) : GALAX TREATMENT CENTER, LLC
Provider Business Mailing Address
First Line : 6183 PASEO DEL NORTE STE 200
Second Line :
City : CARLSBAD
State : CA
Zip : 92011-1151
Country : US
Telephone Number : 615-861-6000
Fax Number :
Provider Business Practice Location Address
First Line : 111 TOWN HOLLOW RD
Second Line :
City : CEDAR BLUFF
State : VA
Zip : 24609-9622
Country : US
Telephone Number : 276-963-3554
Fax Number : 276-963-4653
Authorized Official
Title or Position : VP & SECRETARY
Name : BRIAN PHILLIP FARLEY
Credential :
Telephone Number : 615-861-6000
Provider Enumeration Date : 02/06/2007
Last Update Date : 08/14/2023

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Directions to “GALAX TREATMENT CENTER, LLC ” Practice Location

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