PEACHTREE RECOVERY SOLUTIONS NPI 1063092294

NPI Information

NPI: 1063092294
Provider Name: PEACHTREE RECOVERY SOLUTIONS
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 11D2223318

Address:
3060 BUSINESS PARK DR
SUITE C
NORCROSS, GA
ZIP 30071
Phone: (404) 694-5887
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PEACHTREE RECOVERY SOLUTIONS is a rehabilitation and substance use disorder clinic center in Norcross, GA. PEACHTREE RECOVERY SOLUTIONS NPI is 1063092294. The provider is registered as an organization entity type.

The provider's business location address is:

3060 BUSINESS PARK DR
SUITE C
NORCROSS, GA
ZIP 30071
Phone: (404) 694-5887
Fax: (770) 637-5377

The provider's authorized official is Luke Thurston .
The authorized official title is Executive Director and has the following contact phone number (404) 694-5887.

The CLIA number assigned to this NPI record is 11D2223318 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/12/2021 and was last updated on 4/9/2024.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes
2	324500000X	Substance Abuse Rehabilitation Facility				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	81534	OTHER	GEORGIA	ANA LISA CARR MD

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: 5/5/2024

NPI Synchronization or Removal

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