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ACCESS HEALTH TREATMENT CENTER LLC NPI 1699220475


NPI Information

NPI: 1699220475
Provider Name: ACCESS HEALTH TREATMENT CENTER LLC
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

CLIA Number: 11D2099554

Address:
105 BRADFORD SQ
SUITE A
FAYETTEVILLE, GA
ZIP 30215
Phone: (770) 742-3846
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ACCESS HEALTH TREATMENT CENTER LLC is a methadone clinic center in Fayetteville, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. ACCESS HEALTH TREATMENT CENTER LLC NPI is 1699220475. The provider is registered as an organization entity type.

The provider's business location address is:

105 BRADFORD SQ
SUITE A
FAYETTEVILLE, GA
ZIP 30215-974
Phone: (770) 742-3846
Fax: (770) 742-3855

The provider's authorized official is India C Johnson .
The authorized official title is Ceo/owner and has the following contact phone number (770) 742-3846.

The CLIA number assigned to this NPI record is 11D2099554 - other - methadone maintenance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/22/2016 and was last updated on 8/22/2016.


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
1261QM2800XClinic/CenterMethadoneGEORGIAYes

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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