Mba Wellness Centers

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

NTP001062 Issued in GA

Legal business name

MBA WELLNESS CENTERS

Practice address

1233 Eagles Landing Pkwy
Suite C&D
Stockbridge, GA 30281-6399

Phone

(770) 474-4009

Fax

(770) 474-8003

NPI assigned

Feb 14, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. India C Johnson

Title

Co-Owner

Phone

(770) 474-4009

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360800000000",
    "number": "1174862908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 EAGLES LANDING PKWY",
            "address_2": "SUITE C&D",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816399",
            "telephone_number": "770-474-4009",
            "fax_number": "770-474-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 EAGLES LANDING PKWY",
            "address_2": "SUITE C&D",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816399",
            "telephone_number": "770-474-4009",
            "fax_number": "770-474-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBA WELLNESS CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-14",
        "last_updated": "2013-02-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "INDIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "770-474-4009",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "GA",
            "license": "NTP001062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxcare Medical Center, LLC
• Tatyana May
• Ashlee Nicole Mayberry-Marshall, LPC
• Karaven Mayfield
• Shannon Mayfield, CNM
• Francis L McCafferty Jr., MD
• Kennon Howard McCollum, MSN
• Michael E McConnell, M.D.
• Ashlee McCorkle-Jamieson, M.D.
• Tameka McCrae - Edgecombe, LPC

• Methadone Clinic in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Methadone Clinic in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.