Atlanta Detox Center, LLC

NPI #1679155337 in Riverdale, Georgia

Provider Information

NPI Number: 1679155337
Entity Type: Organization
Organization Name: Atlanta Detox Center, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: ATLANTA DETOX CENTER, LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Apr 22, 2021
Last Updated: Apr 22, 2021

Practice Location

Address: 277 MEDICAL WAY
City: Riverdale
State: Georgia
ZIP Code: 30274-2522
Phone: (470) 298-7236

Authorized Official

Name: JESSIE COSTLEY
Title: LICENSING AND CREDENTIALING SPECIAL
Phone: (410) 807-8471

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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