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Atlanta Detox Center, LLC

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Riverdale, GA

NPI 1679155337 · NPPES record last updated Apr 22, 2021

Key facts

NPI
1679155337
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
ATLANTA DETOX CENTER, LLC
Practice address
277 Medical Way
Riverdale, GA 30274-2522
Phone
(470) 298-7236
Fax
(470) 300-8480
NPI assigned
Apr 22, 2021
Organization subpart
Yes
Parent organization (as reported)
ATLANTA DETOX CENTER, LLC

Authorized official

Name
Jessie Costley
Title
Licensing and Credentialing Special
Phone
(410) 807-8471

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
Atlanta Detox Center LLC (2 organizations share this tax ID)
Part of
Atlanta Detox Center LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

277 Medical Way
Riverdale, GA 30274-2522

Mailing address

277 Medical Way
Riverdale, GA 30274-2522
Phone (470) 298-7236

Other providers in Riverdale, GA

All providers in Riverdale, GA · Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

Sources for this page

Verify at the official NPI Registry.