Southeast Detox LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SOUTHEAST DETOX LLC

Practice address

4300 Martha Berry Hwy NE
Rome, GA 30165-8642

Phone

(770) 217-7832

NPI assigned

Aug 10, 2021

Last updated

Aug 10, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ryan Welch

Title

Partner

Phone

(770) 217-7832

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Pamela Nicole Tambini, M.D.

  • Addiction Medicine (Internal Medicine) Physician
  • Riviera Beach, FL
  • NPI 1396087698
  NPD (past)

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1710652052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 10TH AVE N STE 202",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616612",
            "telephone_number": "561-990-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARTHA BERRY HWY NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301658642",
            "telephone_number": "770-217-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "770-217-7832",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latronja Sockwell
• Hadia Sohail, MBBS
• Ryneth Sok, MD
• Zachary Forrest Solomon, MD
• Robin Williams Sorrow, PHARM.D.
• Southeastern Independent Psychiatry, PC
• Southeastern Pathology, P.C.
• Southeastern Pathology, P.C.
• Southern Home Care Services, Inc. (ResCare HomeCare)
• Southern Home Care Services, Inc.

• Substance Abuse Rehabilitation Facility in Rome, GA
• Providers in Rome, GA by specialty
• Substance Abuse Rehabilitation Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.