Organization Active NPI

Good Landing Recovery Detox and Residential. LLC

  • Substance Abuse Rehabilitation Facility
  • Gainesville, GA
National Provider Identifier
1730816828
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
GOOD LANDING RECOVERY DETOX AND RESIDENTIAL. LLC
Practice address
4141 Old Cornelia Hwy
Gainesville, GA 30507-7784
Phone
(770) 450-6120
Fax
(770) 353-9469
NPI assigned
Aug 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Authorized official

Name
Mr. Robert Pearson Lewis III
Title
Ceo
Phone
(770) 353-9660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

4141 Old Cornelia Hwy
Gainesville, GA 30507-7784

Mailing address

256 McMillan Rd
Dacula, GA 30019-2337
Phone (770) 450-6120

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charlie@goodlandingreecovery.com Direct

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2261873Good Landing Recovery Detox and Residential, LLC4141 Old Cornelia Highway, Gainesville, GA 30507Certificate of waiverJun 6, 2028

National Provider Directory

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": "1659916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1730816828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 MCMILLAN RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192337",
            "telephone_number": "770-450-6120",
            "fax_number": "770-353-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 OLD CORNELIA HWY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305077784",
            "telephone_number": "770-450-6120",
            "fax_number": "770-353-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LANDING RECOVERY DETOX AND RESIDENTIAL. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PEARSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-353-9660",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlie@goodlandingreecovery.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4141 Old Cornelia Hwy",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305077784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.