Warriors Wellness and Recovery Ranch, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WARRIORS WELLNESS AND RECOVERY RANCH, INC.

Practice address

585 Valambrosia Rd
Dublin, GA 31021-0900

Phone

(478) 304-7183

Fax

(877) 298-8388

NPI assigned

Nov 27, 2023

Organization subpart

No

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

Authorized official

Name

Paula Smith, DSW, LCSW, MSW

Title

Co-Founder

Phone

(203) 889-7607

Specialties & licenses 2

Addresses

Other names 1

• Warriors Ranch Other name

Locations

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1750156386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 VALAMBROSIA RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310210900",
            "telephone_number": "478-304-7183",
            "fax_number": "877-298-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 VALAMBROSIA RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310210900",
            "telephone_number": "478-304-7183",
            "fax_number": "877-298-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARRIORS WELLNESS AND RECOVERY RANCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "203-889-7607",
        "authorized_official_credential": "DSW, LCSW, MSW"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Warriors Ranch",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Walgreen Co
• Bethany Heath Walke
• Bet Walker, L.AC
• Chiquail M Walker, LPN
• Deborah Walker, SW
• Griselle Warthen, LMSW
• Shambrea Latavia Washington, PHARM. D.
• Berrien Raymond Waters, M.D.
• Chakina Latasha Watkins
• Jenna Marie Watkins, AGACNP-BC

• All providers in Dublin, GA
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.