MEDICARE: HUGS RECOVERY

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
1	324500000X	Substance Abuse Rehabilitation Facility	060-532-D	GA

General Provider Information

NPI Number	:	1780929968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUGS RECOVERY

Provider Business Mailing Address
First Line	:	1203 CLEVELAND AVE
Second Line	:	2D
City	:	ATLANTA
State	:	GA
Zip	:	30344-3417
Country	:	US
Telephone Number	:	404-228-2222
Fax Number	:	404-228-2923

Provider Business Practice Location Address
First Line	:	1203 CLEVELAND AVE
Second Line	:	2D
City	:	ATLANTA
State	:	GA
Zip	:	30344-3417
Country	:	US
Telephone Number	:	404-228-2222
Fax Number	:	404-228-2923

Authorized Official
Title or Position	:	CEO
Name	:	MR. DERRICK BILLINGSLEA
Credential	:	CNDCS, CCT,CCS
Telephone Number	:	404-228-2222

Provider Enumeration Date	:	11/29/2012
Last Update Date	:	11/29/2012

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