NPIMap

Organization Active NPI

Potters Hands Institute LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Villa Rica, GA
National Provider Identifier
1386964690
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
DRUG000750 Issued in GA
Legal business name
POTTERS HANDS INSTITUTE LLC
Practice address
307 Old Stone Rd
Villa Rica, GA 30180-1214
Phone
(770) 459-8799
Fax
(770) 459-8919
NPI assigned
Jun 9, 2010
Last updated
Jun 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Dr. Mobolaji Oyebanjo
Title
Ceo
Phone
(770) 459-8799

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X DRUG000750 GA Primary

Addresses

Primary practice location

307 Old Stone Rd
Villa Rica, GA 30180-1214

Mailing address

307 Old Stone Rd
Villa Rica, GA 30180-1214
Phone (770) 459-8799

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1386964690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 OLD STONE RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801214",
            "telephone_number": "770-459-8799",
            "fax_number": "770-459-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 OLD STONE RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801214",
            "telephone_number": "770-459-8799",
            "fax_number": "770-459-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTERS HANDS INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "OYEBANJO",
        "authorized_official_first_name": "MOBOLAJI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-459-8799",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "GA",
            "license": "DRUG000750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.