NPIMap

Organization Active NPI

Peachtree Recovery Centers, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Atlanta, GA
National Provider Identifier
1497217715
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PEACHTREE RECOVERY CENTERS, LLC
Practice address
3975 Roswell Rd NE Ste 104
Atlanta, GA 30342-4119
Phone
(770) 807-2022
NPI assigned
Apr 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Authorized official

Name
Wendy Jennings
Title
Owner
Phone
(770) 807-2022

Specialties & licenses 1

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

Addresses

Primary practice location

3975 Roswell Rd NE Ste 104
Atlanta, GA 30342-4119

Mailing address

70 Gruber LN Ste 107
St Simons Island, GA 31522-2888

National Provider Directory

National Provider Directory
Tax ID family
Peachtree Recovery Centers LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1497217715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GRUBER LN STE 107",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 ROSWELL RD NE STE 104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424119",
            "telephone_number": "770-807-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE RECOVERY CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-807-2022"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.