PEACHTREE WELLNESS SOLUTIONS LLC NPI 1245962778

NPI Information

NPI: 1245962778
Provider Name: PEACHTREE WELLNESS SOLUTIONS LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 11D2263679

Address:
100 GOVERNORS TRCE STE 110
PEACHTREE CITY, GA
ZIP 30269
Phone: (513) 497-1982
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PEACHTREE WELLNESS SOLUTIONS LLC is a rehabilitation and substance use disorder clinic center in Peachtree City, GA. PEACHTREE WELLNESS SOLUTIONS LLC NPI is 1245962778. The provider is registered as an organization entity type.

The provider's business location address is:

100 GOVERNORS TRCE STE 110
PEACHTREE CITY, GA
ZIP 30269-853
Phone: (513) 497-1982

The provider's authorized official is Jason Flaig .
The authorized official title is Chief Executive Officer and has the following contact phone number (513) 497-1982.

The CLIA number assigned to this NPI record is 11D2263679 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/24/2022 and was last updated on 4/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health	No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	Yes
3	323P00000X	Psychiatric Residential Treatment Facility		No
4	324500000X	Substance Abuse Rehabilitation Facility		No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	70170	OTHER	GEORGIA	DR. BRYON MCQUIRT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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