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GEORGIA DETOX AND RECOVERY CENTERS LLC MACON NPI 1982099693


NPI Information

NPI: 1982099693
Provider Name: GEORGIA DETOX AND RECOVERY CENTERS, LLC MACON
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 11D0662541

Address:
655 1ST ST
MACON, GA
ZIP 31201
Phone: (561) 868-1607
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GEORGIA DETOX AND RECOVERY CENTERS, LLC MACON is a substance abuse rehabilitation facility in Macon, GA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. GEORGIA DETOX AND RECOVERY CENTERS, LLC MACON NPI is 1982099693. The provider is registered as an organization entity type.

The provider's business location address is:

655 1ST ST
MACON, GA
ZIP 31201-852
Phone: (561) 868-1607
Fax: (561) 697-4345

The provider's authorized official is Jean Dockery .
The authorized official title is Director Of Patient Accounts and has the following contact phone number (561) 868-1607.

The CLIA number assigned to this NPI record is 11D0662541 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/31/2015 and was last updated on 9/8/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation Facility121-253-DGEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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