Willow Creek Adolescent Substance Abuse Program

NPI #1114174331 in Ellijay, Georgia

Provider Information

NPI Number: 1114174331
Entity Type: Organization
Organization Name: Willow Creek Adolescent Substance Abuse Program
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Enumeration Date: Aug 19, 2008
Last Updated: Aug 19, 2008

Practice Location

Address: 10 KIKER ST
City: Ellijay
State: Georgia
ZIP Code: 30540-3700
Phone: (706) 636-2692

Authorized Official

Name: MR. LARRY W HOOKS
Title: CEO AND DIRECTOR
Phone: (706) 636-2692

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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