Georgia Recovery Campus,LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

GEORGIA RECOVERY CAMPUS,LLC

Practice address

211 Goose Hollow Rd
Reynolds, GA 31076-3505

Phone

(478) 663-2222

NPI assigned

May 24, 2023

Organization subpart

No

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

Authorized official

Name

Amber Blacklock

Title

Director of Operations

Phone

(678) 769-6594

Specialties & licenses 2

Addresses

Tax ID family

Georgia Recovery Campus Augusta4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Georgia Recovery Campus,LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Columbus, GA
  • NPI 1346117959
  NPD tax ID
• Georgia Recovery Campus,LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Augusta, GA
  • NPI 1841146362
  NPD tax ID
• Georgia Recovery Campus,LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Macon, GA
  • NPI 1922988286
  NPD tax ID

Locations

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1952093114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 GOOSE HOLLOW RD",
            "city": "REYNOLDS",
            "state": "GA",
            "postal_code": "310763505",
            "telephone_number": "478-663-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 GOOSE HOLLOW RD",
            "city": "REYNOLDS",
            "state": "GA",
            "postal_code": "310763505",
            "telephone_number": "478-663-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA RECOVERY CAMPUS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "BLACKLOCK",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "678-769-6594"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Alison Broussard, NP
• Thomas Prier Callier IV, MD
• Ilana Diallo
• Angela Leigh Eubanks, MSN, PMHNP-BC
• Georgia Behavioral Campus LLC
• Laspanya Hunter
• Jonathan Julian Knight, PHARMD
• Tammi Martin Knight, PHARMD
• Macon County Medical Center
• Randall Colby Nelson, AGNP-C

• Substance Abuse Rehabilitation Facility in Reynolds, GA
• Providers in Reynolds, 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 Apr 14, 2026; 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.