NPIMap

Organization Active NPI

Georgia Detox and Recovery Centers, LLC Macon

  • Substance Abuse Rehabilitation Facility
  • Macon, GA
National Provider Identifier
1982099693
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
121-253-D Issued in GA
Legal business name
GEORGIA DETOX AND RECOVERY CENTERS, LLC MACON
Practice address
655 1St St
Macon, GA 31201-2852
Phone
(561) 868-1607
Fax
(561) 697-4345
NPI assigned
Mar 31, 2015
Last updated
Sep 8, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
RIVERMEND HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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

Authorized official

Name
Jean Dockery
Title
Director of Patient Accounts
Phone
(561) 868-1607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 121-253-D GA Primary

Addresses

Primary practice location

655 1St St
Macon, GA 31201-2852

Mailing address

2300 Windy Ridge Parkway
Suite 210 South
Atlanta, GA 30339
Phone (561) 868-1607

National Provider Directory

National Provider Directory
Tax ID family
Georgia Detox and Recovery Centers LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

655 1st St
Macon, GA 31201
Phone (478) 301-5930

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504828800000",
    "number": "1982099693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WINDY RIDGE PARKWAY",
            "address_2": "SUITE 210 SOUTH",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30339",
            "telephone_number": "561-868-1607",
            "fax_number": "561-697-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 1ST ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012852",
            "telephone_number": "561-868-1607",
            "fax_number": "561-697-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DETOX AND RECOVERY CENTERS, LLC MACON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERMEND HEALTH",
        "enumeration_date": "2015-03-31",
        "last_updated": "2017-09-08",
        "status": "A",
        "authorized_official_last_name": "DOCKERY",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "561-868-1607"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "GA",
            "license": "121-253-D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; 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.