| NPI | 1982819595 |
|---|---|
| Doing Business As | NORTHWEST GEORGIA TREATMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | MARIA JACKSON CFO 407-351-7080 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 251S00000X (Licence: GA NA) |
| 3336C0002X Pharmacy, Clinic Pharmacy (Licence: GA PHOP000002) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2022-11-04 |