Marietta Recovery Centers, Inc

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

MARIETTA RECOVERY CENTERS, INC

Practice address

70 Gruber LN
Suite 107
St Simons Island, GA 31522-2881

Phone

(404) 237-5519

Fax

(404) 262-2557

NPI assigned

Jun 7, 2016

Organization subpart

No

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

Authorized official

Name

Wendy Jennings

Title

Owner

Phone

(954) 800-8387

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1538518931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 KENNESTONE CIR",
            "address_2": "SUITE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666009",
            "telephone_number": "404-237-5519",
            "fax_number": "404-262-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GRUBER LN",
            "address_2": "SUITE 107",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222881",
            "telephone_number": "404-237-5519",
            "fax_number": "404-262-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIETTA RECOVERY CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-800-8387"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah E Lyons, DPT, PT
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• Robin Leigh Marshal, PTA
• Mary R Parker MPT PC
• Angela Lynn Mason, MS,PT
• Gidget Bragg Maybin

• Substance Use Disorder Rehabilitation Clinic/Center in St Simons Island, GA
• Providers in St Simons Island, 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 Dec 29, 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.