HEALTHQWEST FRONTIERS LLC NPI 1043631476

NPI Information

NPI: 1043631476
Provider Name: HEALTHQWEST FRONTIERS LLC
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

CLIA Number: 11D2065710

Address:
890 NORTHWOODS PLAZA
MACON, GA
ZIP 31204
Phone: (478) 330-7164
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HEALTHQWEST FRONTIERS LLC is a methadone clinic center in Macon, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. HEALTHQWEST FRONTIERS LLC NPI is 1043631476. The provider is registered as an organization entity type.

The provider's business location address is:

890 NORTHWOODS PLAZA
MACON, GA
ZIP 31204-441
Phone: (478) 330-7164

The provider's authorized official is Robyn Tanis .
The authorized official title is Executive Director Of Contract Mgmt and has the following contact phone number (856) 533-8762.

The CLIA number assigned to this NPI record is 11D2065710 - other - opioid treatment program with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/3/2014 and was last updated on 3/4/2024.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM2800X	Clinic/Center	Methadone	NTP001074	GEORGIA	Yes
2	261QR0800X	Clinic/Center	Recovery Care			No

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

NPI Synchronization or Removal

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