Saint Andrews Outpatient Services, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SAINT ANDREWS OUTPATIENT SERVICES, LLC

Practice address

1290 Kennestone Cir
Suite102
Marietta, GA 30066-6009

Phone

(404) 237-5519

Fax

(404) 262-2557

NPI assigned

Oct 5, 2016

Organization subpart

No

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

Authorized official

Name

Bud Hearn

Title

Owner

Phone

(404) 606-0030

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1396295127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GRUBER LN",
            "address_2": "SUITE 107",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222881",
            "telephone_number": "404-606-0030",
            "fax_number": "404-262-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 KENNESTONE CIR",
            "address_2": "SUITE102",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666009",
            "telephone_number": "404-237-5519",
            "fax_number": "404-262-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ANDREWS OUTPATIENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "HEARN",
        "authorized_official_first_name": "BUD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-606-0030"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Marietta, GA
• Providers in Marietta, GA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.