| NPI | 1619766219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBENEZER ADEKUNLE KOLADE Vice President 470-903-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2025-08-21 |