SOUTHERN WELLNESS SERVICES LLC NPI 1841956364

NPI Information

NPI: 1841956364
Provider Name: SOUTHERN WELLNESS SERVICES, LLC

Doing Business As: EMPOWERED RECOVERY CENTER

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
3651 CANTON RD
MARIETTA, GA
ZIP 30066
Phone: (470) 295-3152
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SOUTHERN WELLNESS SERVICES, LLC is a rehabilitation and substance use disorder clinic center in Marietta, GA. SOUTHERN WELLNESS SERVICES, LLC NPI is 1841956364. The provider is registered as an organization entity type.
The provider Is Doing Business As Empowered Recovery Center.

The provider's business location address is:

3651 CANTON RD
MARIETTA, GA
ZIP 30066-600
Phone: (470) 295-3152
Fax: (678) 623-3318

The provider's authorized official is Forrest Richardson .
The authorized official title is Coo and has the following contact phone number (470) 295-3152.

The CLIA number assigned to this NPI record is 11D2242348 - other - substance abuse treat ctr with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/9/2021 and was last updated on 11/19/2021.

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

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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