MBA WELLNESS CENTERS NPI 1174862908

NPI Information

  • NPI: 1174862908
  • Provider Name: MBA WELLNESS CENTERS
  • Classification: Clinic/Center - 261QM2800X
  • Specialization: Methadone
  • Entity Type: Organization
  • CLIA Number: 11D2010191
  • Address: 1233 EAGLES LANDING PKWY
    SUITE C&D
    STOCKBRIDGE, GA
    ZIP 30281
  • Phone: (770) 474-4009

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NPI Details

MBA WELLNESS CENTERS is a methadone clinic center in Stockbridge, 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. MBA WELLNESS CENTERS NPI is 1174862908. The provider is registered as an organization entity type.

The provider's business location address is:

1233 EAGLES LANDING PKWY
SUITE C&D
STOCKBRIDGE, GA
ZIP 30281-399
Phone: (770) 474-4009
Fax: (770) 474-8003

The provider's authorized official is India C Johnson .
The authorized official title is Co-owner and has the following contact phone number (770) 474-4009.

The CLIA number assigned to this NPI record is 11D2010191 - other - substance abuse tx center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/14/2013 and was last updated on 2/14/2013.

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
1261QM2800XClinic/CenterMethadoneNTP001062GEORGIAYes

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: 11/21/2025

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