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PENFIELD ADDICTION MINISTRIES INC. NPI 1609411321


NPI Information

NPI: 1609411321
Provider Name: PENFIELD ADDICTION MINISTRIES, INC.
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 11D2165504

Address:
1061 MERCER CIR
UNION POINT, GA
ZIP 30669
Phone: (706) 453-7929
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PENFIELD ADDICTION MINISTRIES, INC. is a substance abuse rehabilitation facility in Union Point, GA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. PENFIELD ADDICTION MINISTRIES, INC. NPI is 1609411321. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1061 MERCER CIR
UNION POINT, GA
ZIP 30669-205
Phone: (706) 453-7929

The provider's authorized official is Andrew Michael Metzger .
The authorized official title is Cqi-rm Supervisor and has the following contact phone number (706) 817-4589.

The CLIA number assigned to this NPI record is 11D2165504 - other - addiction treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/18/2019 and was last updated on 11/18/2019.


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 License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2324500000XSubstance Abuse Rehabilitation FacilityYes

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

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